Registration Clerk

Talentify; West Plains (MO); On-site; USD 38,000 - 46,000; Full time

Job summary

Talentify is seeking an Insurance & Compliance Specialist to perform compliant checks on admitted patients' accounts and verify insurance benefits. You will ensure documentation aligns with test orders, diagnoses, and physician orders for Medical Records review.

The role includes completing Medicare Secondary Payer questionnaires, obtaining authorizations, and supporting accurate billing by verifying pre-admission requirements and payer rules.

Qualifications

• Verifies patient insurance eligibility and benefits.
• Obtains authorizations and pre-certifications as required.
• Adheres to federal guidelines for Medicare/Medicaid and commercial payers.

Responsibilities

• Compliant check on admitted patients' accounts.
• Ensures written documentation with test orders, diagnosis, and physician orders is available for Medical Records review.
• Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients.
• Verifies insurance eligibility and benefits for admissions and services.
• Obtains pre-admission/pree-certifications and insurance verification to support accurate billing.

Skills

Insurance verification

Pre-certification

Medicare/Medicaid knowledge

Documentation review

Job description

Compliant check on admitted patients' accounts. Insuring account is accurate

Compliance checks all appropriate diagnosis codes and procedures in the order checker system, ensuring that written documentation with the test ordered, diagnosis and physician order is available for Medical Records staff to review.

Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients.

Verifies insurance Eligibility and Benefits

Obtain authorizations and pre-certification for all admitted patients as needed per patient insurance plan.

Obtains pre –admission/pre-certifications/insurance verification to support accurate billing and collections. Fully understands and adheres to the rules and regulations of Medicare, Medicaid, Managed Care and Commercial payers regarding pre-authorization, and pre-certification requirements.

Responsible for reviewing and ensuring accuracy of patient’s insurance coverage information, determining primary payer when coordination of benefits is required.

Must be knowledgeable and adhere to all federal guidelines regarding patient registration and reimbursement. Understands inpatient reimbursement and requirements of guidelines per Medicare, Medicaid, Manage Care, and commercial payers. Serves as a resource for others.

Various projects as requested by supervisor