Trinity Health, Mid-Atlantic, is looking for an Insurance Verification Specialist to join our team!
The Insurance Verification Specialist is responsible for obtaining and verifying accurate insurance information, benefit validation, authorization and preservice collections on all qualifying accounts.
This is a key position that will begin the overall patient experience and initiates the billing process for any services provided by the hospital.
The Insurance Verification Specialist:
- Financially clears patients for each visit type, admit type and area of service via current HIS (Health Information System).
- Collects and documents all required demographic and financial information. Appropriately activates registration and canceled or no-show accounts in a timely fashion.
- Analyzes patient insurance(s), identifies the correct insurance plan, selects appropriately from HIS insurance and plan selections and documents correct insurance order. Applies recurring visit processing according to protocol.
- Verifies patient information with third party payers. Collects insurance referrals and documents within HIS. Communicates with patients and physician/offices regarding authorization/referral requirements. Identifies potential need for financial responsibility forms or completed electronic forms with patients as necessary. Escalates accounts appropriately in accordance with department Defer/Delay policy to manager.
- Screens outpatient visits for medical necessity and issues Advanced Beneficiary Notice as appropriate for Medicare primary outpatients. Provides cost estimates. Collects and documents Medicare Questionnaire and obtains information from the patient if third party payers need to be billed (i.e. worker's compensation, motor vehicle accidents and any other applicable payer).
- Maintains operational knowledge of regulatory requirements and guidelines as outlined in the hospital and department Compliance Plans. Ensures Meaningful Use requirements are met as appropriate.
We offer a competitive salary and comprehensive benefits including:
- HS diploma or equivalency [required]
- Associate's degree [preferred]
- Insurance verification, patient registration experience [preferred]
Our Commitment to Diversity and Inclusion
- Medical, Dental, & Vision Coverage
- Retirement Savings Program
- Paid Time Off
- Tuition Reimbursement
- Free Parking
- And more!
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.