Patient Financial Clearance | Insurance Verifier

U.S. Dermatology Partners; Tyler (TX); Presencial; USD 42 000 - 54 000; Tempo integral

Resumo da oferta

US Dermatology Partners is seeking a Patient Financial Clearance Specialist to verify insurance eligibility and benefits for scheduled patients, and ensure timely, compliant processing. Responsibilities include coordinating COB, contacting payers and patients, entering data in NextGen, and applying the practice’s financial policies to determine out-of-pocket responsibility.

This role supports center compliance with CMS guidelines, tracks claim issues and improves workflows through policy and

Responsabilidades

• Verify that sufficient information is available for accurate verification and eligibility.
• Determine if a secondary and/or tertiary insurance should be added to the patient’s account ensuring the appropriate payer is selected for Primary insurance.
• Accurately ensure coordination of benefits (COB) is calculated and set up accordingly in NextGen.
• Utilize Rivet, Availity, payer portals and/or contact insurance companies to obtain eligibility, benefits, and/or referral and authorization information.
• Enter the patient insurance information into NextGen ensuring the selection is the appropriate payer and associated financial class.
• Follow the Policies and Procedures when accepting Out of Network payers along with notifying the patient immediately.
• Ensures each patient’s insurance verification is completed and accurate. Document findings in the patient account and contact the patient with either estimated co-insurance, co-pay, and or deductible amounts due on or before the date of service when applicable.
• Contacts each patient as part of center compliance with CMS Conditions for Coverage guidelines in contacting patients prior to the date of service to review patient’s responsibility.
• Check insurance company approved procedure lists/medical policies. Notify patient if procedure is not payable and options per USDP’s Self-Pay agreement.
• Obtain authorizations and/or referrals from insurance companies/physician’s offices. Ensure complete and accurate information is included on the authorization and entered into NextGen.
• Contact the patient and communicate USDP’s financial policy, when applicable.
• Resolve Claim Edits associated with authorizations, demographics, and insurance.
• Track and report trending data associated with claim edits to manager.
• Work and resolve patient insurance-related tasks. Track repeat tasks and provide to manager.
• Assist with workflow optimization through piloting new procedures, applications, and policies. Track and report findings to manager.
• Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.
• Performs other duties that may be necessary or in the best interest of the organization.

Descrição da oferta de emprego

US Dermatology Partners is seeking a Patient Financial Clearance Specialist to verify insurance eligibility and benefits for scheduled patients, and ensure timely, compliant processing. Responsibilities include coordinating COB, contacting payers and patients, entering data in NextGen, and applying the practice’s financial policies to determine out-of-pocket responsibility.

This role supports center compliance with CMS guidelines, tracks claim issues and improves workflows through policy and