Job Description

GENERAL SUMMARY OF DUTIES

The Insurance Verification Clerk is responsible for answering calls benefits verification and precertification. Customer service should be provided that meets and exceeds internal and external customer expectations. All staff must practice high standards of performance and always maintain superior customer service for all responsibilities.

REQUIREMENTS

• High school diploma or equivalent
• Minimum of 3 years of prior medical experience
• Working knowledge of MS Office applications including Outlook Word and Excel
• Ability to effectively interface with insurance carriers Case Management/Utilization Review Registration and Business Office staff
• Ability to read write and comprehend documents correspondence and memos
• Ability to present information clearly in both one-on-one and group settings to patients clients and internal staff
• Ability to apply common-sense understanding to follow written oral and diagram-based instructions
• Strong critical-thinking skills
• Effective time-management skills
• Proficient PC skills
• Epic experience required

ESSENTIAL FUNCTIONS

• Act as liaison between patients physician office and insurance company to assist with regards to financial responsibility and obtaining authorization
• Verify patient insurance eligibility and benefits using payer portals and payer representatives to ensure compliance with the facilities policies and procedures
• Coordinate with insurance providers and the physician office to obtain pre-authorizations. Document these findings as instructed.
• Obtain information for medical necessity determination and coordinate with the physician office if additional information is needed
• Communicate with patients to obtain any missing information necessary to achieve financial clearance
• Conduct benefit verifications on all new and existing patients when requested
• Cross train as required to assist with overflow responsibilities
• Exhibit flexibility in work schedules and assigned tasks
• Maintain minimal error rate
• Maintain productivity as requested by Business Office Director
• Maintain supplies and forms necessary to perform duties
• Participates in group meetings and /or various committees
• Making suggestions on workflow improvements
• Notify Supervisor of any issues
• Maintain a positive attitude toward position and responsibilities
• Other duties as assigned by Supervisor

PHYSICAL DEMANDS

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
• While performing the duties of this job the employee is frequently required to sit converse and listen; use hands to touch handle or feel objects tools or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus.
• The employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a regular basis.
• The employee must be able to stand and/or walk at least five hours per day.

WORK ENVIRONMENT

• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function.

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