The Insurance Verifier is responsible for verifying that all patients either admitted to the facility or in a day surgery procedure have a verified method for the payment of the charges to be incurred. All demographic information, insurance information, PCP information and notes are to be verified to make sure every field in the computer is filled out completely and correctly. Operates computer to enter and retrieve data. Maintains effective communication skills, including verbal, written, and telephone. Proficient in mathematical skills. The admitting Rep Interview patient/patient’s demographic and insurance information. Ability to communicate with school-age, adolescent, young adult, middle adult, and older adults. (Advance Directives, medical necessity determination; Medicare Secondary Payer completion and coordination of benefits; Important Message from Medicare issuance, HIPAA policy, and Patient Rights distribution; and EMTALA). Ability to communicate concisely and clearly is important. Critical thinking skills for problem resolution are required. Essential is the ability to provide excellent customer service to patients, patients’ family members, healthcare providers, medical staff offices, and peers.
Demonstrates Competency in the Following Areas
- Strong interpersonal/public relations skills.
- Ability to work effectively with a wide range of customers in a diverse environment.
- Knowledge of Medicare, Medicaid, Commercial and HMO payers.
- Ability to perform analytical problem-solving.
- Ability to perform basic math.
- Ability to operate concurrently within a variety of hospital systems.
- Working knowledge of PC applications, Word, Excel, etc.
- Keyboarding skills.
- Knowledge of organizational structure, workflow, and operating procedures.
- Strong oral and written communication skills.
- Organization and time management skills.
- Ability to follow directions and establish priorities effectively.
- Self-directed and capable of working without direct supervision.
- Dependable in both production and attendance.
- Demonstrates the ability to be flexible, organized, and function well under stressful situations.
- High school graduate or equivalent required.
- Bilingual capability (English/Spanish) desired.