NorthEast Provider Solutions Inc.
Lead Insurance Verifier
NorthEast Provider Solutions Inc., Valhalla, New York, United States, 10595
Job Details:Job Summary:
The Lead Insurance Verifier is responsible for leading the financial clearance team, ensuring patients receiving services at our organization are financially cleared. This individual is responsible for obtaining timely and accurate authorizations for all hospital services where needed and ensuring that patients are contacted timely regarding their financial responsibility (when applicable). The Lead Insurance Verifier will also perform other tasks as assigned by Patient Access leadership.
Responsibilities:
This position is responsible for the day-to-day operations of the MHRH verification department that verifies various types of insurance benefits from simple office visits to very complex surgical and medical procedures, securing authorization, and notification for inpatient and outpatient surgery, diagnostic testing, and inpatient admissions for account information for reimbursement.
Prepares written estimates per patient and calculates estimated patient responsibility based on scheduled procedures and insurance allowable per managed care grid.
Ensures coordination and communication between departments, becoming a resource for the patient, physician, and facility. Communicates with Doctor’s office staff regarding issues with patients such as difficulty reaching the patient or inability to make an acceptable financial arrangement.
Responsible for ensuring patient satisfaction as it relates to securing accounts prior to the patient’s arrival at the medical centers.
Essential that this information be documented timely and accurately.
Reviews eligibility discrepancies.
Ensures Admission Notification has been completed and verifies insurance eligibility.
Ensures Motor Vehicle Accident, Workers Compensation, or other Third Party Liability paperwork has been completed.
Maintains current knowledge of and competency with numerous Federal, State, and other regulatory body compliance regulations and third-party insurance plans.
Must be able to follow directions and perform work according to department standards when no directions are given.
Reviews reporting to identify missed authorizations which will be provided to the appropriate verifier or obtains the authorization/referral to ensure that it is obtained.
Basic knowledge of patient accounting and insurance systems.
Accountable for maintaining a close working relationship with teammates, point of service registrars, departmental staff, and physician’s offices.
Communicates with all customers (patients, families, staff, physicians, vendors, etc.) in a helpful and courteous manner while extending exemplary customer service.
Qualifications/Requirements:
Experience:
A minimum of one year of experience in patient access/insurance verification preferred.
Education:
High school graduate or equivalent.
Licenses / Certifications:
N/A
Other:
Knowledge of HDX, Cerner Millennium, Invision preferred. Must possess excellent communication skills and the ability to conduct themselves in a professional manner at all times. Must have good problem-solving skills and the ability to know when to seek assistance to ensure positive customer relations.
About Us:
NorthEast Provider Solutions Inc.
Benefits:
We offer a comprehensive compensation and benefits package that includes:
Health Insurance
Dental
Vision
Retirement Savings Plan
Flexible Savings Account
Paid Time Off
Holidays
Tuition Reimbursement
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The Lead Insurance Verifier is responsible for leading the financial clearance team, ensuring patients receiving services at our organization are financially cleared. This individual is responsible for obtaining timely and accurate authorizations for all hospital services where needed and ensuring that patients are contacted timely regarding their financial responsibility (when applicable). The Lead Insurance Verifier will also perform other tasks as assigned by Patient Access leadership.
Responsibilities:
This position is responsible for the day-to-day operations of the MHRH verification department that verifies various types of insurance benefits from simple office visits to very complex surgical and medical procedures, securing authorization, and notification for inpatient and outpatient surgery, diagnostic testing, and inpatient admissions for account information for reimbursement.
Prepares written estimates per patient and calculates estimated patient responsibility based on scheduled procedures and insurance allowable per managed care grid.
Ensures coordination and communication between departments, becoming a resource for the patient, physician, and facility. Communicates with Doctor’s office staff regarding issues with patients such as difficulty reaching the patient or inability to make an acceptable financial arrangement.
Responsible for ensuring patient satisfaction as it relates to securing accounts prior to the patient’s arrival at the medical centers.
Essential that this information be documented timely and accurately.
Reviews eligibility discrepancies.
Ensures Admission Notification has been completed and verifies insurance eligibility.
Ensures Motor Vehicle Accident, Workers Compensation, or other Third Party Liability paperwork has been completed.
Maintains current knowledge of and competency with numerous Federal, State, and other regulatory body compliance regulations and third-party insurance plans.
Must be able to follow directions and perform work according to department standards when no directions are given.
Reviews reporting to identify missed authorizations which will be provided to the appropriate verifier or obtains the authorization/referral to ensure that it is obtained.
Basic knowledge of patient accounting and insurance systems.
Accountable for maintaining a close working relationship with teammates, point of service registrars, departmental staff, and physician’s offices.
Communicates with all customers (patients, families, staff, physicians, vendors, etc.) in a helpful and courteous manner while extending exemplary customer service.
Qualifications/Requirements:
Experience:
A minimum of one year of experience in patient access/insurance verification preferred.
Education:
High school graduate or equivalent.
Licenses / Certifications:
N/A
Other:
Knowledge of HDX, Cerner Millennium, Invision preferred. Must possess excellent communication skills and the ability to conduct themselves in a professional manner at all times. Must have good problem-solving skills and the ability to know when to seek assistance to ensure positive customer relations.
About Us:
NorthEast Provider Solutions Inc.
Benefits:
We offer a comprehensive compensation and benefits package that includes:
Health Insurance
Dental
Vision
Retirement Savings Plan
Flexible Savings Account
Paid Time Off
Holidays
Tuition Reimbursement
#J-18808-Ljbffr