Insurance Verification Representative - Per Diem

Could you be our next per diem Insurance Verification Representative?

Why work as an Insurance Verification Rep, Per Diem

• Make an Impact! The Insurance Verification Rep is responsible to confirm the financial/insurance information obtained during the registration process to determine that State, Federal and Third-Party precertification requirements for payment are met. This includes ensuring the completion of insurance verification, benefits and eligibility and pre-certification for hospital admissions as well as accurate documentation in Epic. This position performs complex insurance verification and eligibility determinations including investigative and problem-solving activities to support minimization of financial risk and optimal reimbursement.
  
  
• Join the Team!

Essential Accountabilities include:

• Process registrations within 1-business day of admission for urgent and emergent admissions.
• Review all demographic information, correcting as needed.
• Accurately verify all insurance plans and Coordination of Benefits.
• Accurately verify all third-party sponsorship by phone or electronically (RTE, payor portals, PROMISE, Novitasphere etc).
• Obtain pre-certification on all urgent and emergent admissions.
• Identifies copayment, deductible and co-insurance information.
• Ensure that pre-certification was obtained for all other admissions.
• Contacts physicians, their office staff and patient to obtain necessary information to complete the pre-certification process
• Acts as resource person for MLH for precertification issues and assists with patient accounting issues
• Manages Retrospective Review requests which may include calling payors, use of portals and/or provision of medical records as required.5. Monitors individual payers for specific contractual requirements.
• Works in conjunction with the billing staff to ensure clean billing.

• Must be willing to assist other departments with insurance eligibility, benefit and precertification questions.

• Ensures quality, timeliness, and compliance with MLH and regulatory requirements.
• Understanding of third-party reimbursement and methodologies for all third-party payers specifically pre-certification and Coordination of Benefits (COB) regulations.
• Develops and achieves departmental and professional goals annually.
  
• Position: Insurance Verification Representative, Per Diem
  Shift: Day Shift, Rotating Sundays as needed - anticipated 16 hours per week
  
  Experience:
• Must have working knowledge of Medicare, Medicaid, commercial, managed care rules, regulations and familiarity with medical terminology- 1 year required.
• 2+ year's of experience in recent work within patient registration or financial; counseling department.
• Working knowledge of patient management and patient accounting computer systems required.
  
  Education:
  High school or GED
  
  Licensures/Certifications:
  N/A