Health Insurance Verification Specialist
Company: Tuality Healthcare
Posted on: June 23, 2022
The Insurance Verification Specialist is responsible for (but not
limited to) verification of all insurance to determine actual
benefits of in-patient and outpatient procedural and admitted
accounts requiring an extensive knowledge on medical insurance.
Notifies all insurance companies of outpatient and inpatient
admissions for authorization, audits IP/OP procedural accounts,
obtains prior authorizations for facility services that require
such. Provides excellent customer service to patient and staff
Performed majority of the time:
* Obtains needed insurance, health and financial information on
patients coming into the hospital.
* Updates patient accounts as needed.
* Communicates to patient the patient's financial responsibility as
* Obtains and verifies insurance within department standard and
ensures proper insurance authorization is obtained.
* Responds to voicemail within 24 hrs.
* Maintains equipment and reports equipment failures promptly to
* Refers accounts that do not have insurance to the Financial
* Addresses Case Management concerns and complaints.
* Attends department meetings and provides insurance updates to the
* Reviews active medical records for presence of diagnosis and
Performed occasionally but critical to successful performance of
* Formulates and updates policies and procedures for insurance
Decision making and budget responsibilities:
Assigned direct reports (not limited to the ones listed):
* Associate degree with college accounting courses or equivalent
* Minimum one (1) year of hospital and insurance verification
Licenses, Certifications and/or Registrations:
Job Related Skills, Abilities and Behaviors:
* Computer experience.
* Demonstrates proper, professional appearance and personal conduct
for the employee's particular job.
* Insurance contracting knowledge preferred.
* Must have the ability to organize and prioritize large volumes of
work, while supporting the needs and work load of your immediate
team members and management.
* Experience working with highly confidential
* Medical billing and insurance terminology required.
* Medical terminology required.
* Requires self-discipline and sense of responsibility, as job
requires strict attention to detail.
* Excellent customer service skills.
* Must be effective in verbal and written communication.
* Uses effective communication skills.
* Ability to read and understand physician's orders.
* Utilizes electronic equipment and communication devices.
* Effectively uses online data bases throughout the insurance
* Assumes responsibility for maintaining competency in all areas
where training was completed.
* Demonstrates confidentiality regarding patient and co-worker
information according to PHI level of access.
* Prioritizes workload.
* Looks for ways to improve customer service.
* Formulates and uses effective working relationships with all
healthcare team members, patients and significant others.
* Fosters positive work environment through teamwork and
* Demonstrates the ability to be self-disciplined, motivated and a
* Bilingual skills a plus.
* Additional Posting Information
Hillsboro Medical Center believes in providing equal employment
opportunities for all qualified individuals. Recruitment, hiring,
promotions, transfers, working conditions, training, and
compensation will be based on qualifications without regard to
race, color, sex, sexual orientation, gender identity, religion,
age, creed, national origin, marital status, family relationship,
veteran status, genetic information, physical or mental disability,
or any other status or characteristic protected by applicable law.
We further commit ourselves to continuing the practical application
of this policy in our daily business conduct.
Keywords: Tuality Healthcare, Hillsboro , Health Insurance Verification Specialist, Healthcare , Hillsboro, Oregon
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