Insurance Verification Specialist
Company: Hillsboro Medical Center
Location: Hillsboro
Posted on: June 23, 2022
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Job Description:
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
alike.KEY RESPONSIBILITIESPerformed 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
needed. - 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 facilitate repairs. - Refers
accounts that do not have insurance to the Financial Counselor. -
Addresses Case Management concerns and complaints. - Attends
department meetings and provides insurance updates to the team. -
Reviews active medical records for presence of diagnosis and
orders.Performed occasionally but critical to successful
performance of the job: - Formulates and updates policies and
procedures for insurance verification. Decision making and budget
responsibilities: - N/AAssigned direct reports (not limited to the
ones listed): - N/AJOB SPECIFICATIONSEducation:Required -
N/APreferred - Associate degree with college accounting courses or
equivalent accounting experience.Experience:Required - Minimum one
(1) year of hospital and insurance verification
experience.Preferred - N/ALicenses, Certifications and/or
Registrations:Required - N/APreferred - N/AJob Related Skills,
Abilities and Behaviors:Required - 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 material/information. -
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 verification process. -
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 assistance. - Demonstrates the ability to be
self-disciplined, motivated and a self-starter.Preferred -
Bilingual skills a plus.Other:Required - Preferred - 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: Hillsboro Medical Center, Hillsboro , Insurance Verification Specialist, Other , Hillsboro, Oregon
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