Job Abstract

Insurance Verifier

ESSENTIAL FUNCTIONS:

1. Ensure all records are maintained in absolute integrity and in compliance with applicable regulations and requirements.
2. Obtaining required referrals and authorizations via phone, fax, on-line, etc.
3. Review reports daily for patients requiring authorizations, pre-notification, and insurance benefit verification.
4. Obtaining retro-authorizations or updating existing authorizations in a timely manner.
5. Data entry in a fast-paced environment with high expectation on accuracy.
6. Updates the patient account with details of the insurance verification.
7. Coordinating with patients regarding their insurance benefits.
8. Identifies deductibles, co-pays, and self-pay accounts.
9. Notifying the appropriate staff members if treatment or service is denied.
10. Re-verify patients monthly for active, current insurance.
11. Assist manager and other staff with account questions when presented.
12. Perform other duties as assigned.
13. Relies on experience and judgment to plan and accomplish goals.

EDUCATION: High School, with 1-2 years experience in healthcare insurance billing and verification, collections and/or authorizations.

KNOWLEDGE:

1. Knowledge of clinic policies and procedures.
2. Knowledge of managed care contracts and utilization.
3. Knowledge of computer systems, programs and spreadsheet applications.
4. Knowledge of medical terminology.
5. Knowledge of CPT/ICD-10

SKILLS:

1. Skill in gathering and reporting claim information.
2. Skill in solving utilization problems.
3. Skill in written and verbal communication and customer relations.

Scheduler

ESSENTIAL FUNCTIONS:

• Counseling patients and scheduling surgeries for multiple physicians.
• Schedule surgeries and work with primary care physicians on a daily basis to ensure each patient has their history and physicals completed prior to surgery.
• Complete all necessary paperwork for each procedure on the physicians’ schedule.
• Precertify any procedures on the schedule that require pre-certification.
• Must be capable of multi-tasking and working with a diverse patient population.
• Provide back up support for the Front Office as needed.
• Other duties as needed.

EDUCATION/EXPERIENCE:

• High School
• 2 years of previous experience scheduling appointments and/or surgeries
• Experience with insurance

KNOWLEDGE:

• Knowledge of clinic policies and procedures.
• Knowledge of managed care contracts and utilization.
• Knowledge of computer systems, programs and spreadsheet applications.
• Knowledge of medical terminology and be familiar with scheduling software.

SKILLS:

• Skill in gathering and reporting claim information.
• Skill in solving utilization problems.
• Skill in written and verbal communication and customer relations.
• Experience in a medical office as a scheduler.
• Fast and accurate data entry.
• Service oriented, patient demeanor.

Benefits:

Full-time:

• Comprehensive health, dental, and vision insurance
• Health Savings Account with an employer contribution
• Life Insurance
• PTO
• 401(k) retirement plan with a company match
• And more!

Equal Employment Opportunity & Work Force Diversity

Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc. Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization.