Insurance Verification Representative I – Pre-Visit Services

🌍 Remote, USA 🎯 Full-time 🕐 Posted Recently

Job Description

    Job Description:
  • Perform pre-registration and insurance verification for inpatient and outpatient services.
  • Follow scripted benefits verification and pre-certification format in the EMR and document results.
  • Contact patients to confirm or obtain missing demographic information, quote/collect patient cost share, and provide appointment instructions.
  • Assign insurance plans accurately and perform electronic eligibility confirmation.
  • Complete Medicare Secondary Payor Questionnaire as applicable.
  • Calculate patient cost share and arrange payment or collection via phone.
  • Research patient visit history to ensure compliance with payor-specific rules (e.g., Medicare 72-hour rule).
  • Communicate with physicians and case managers to resolve authorization or referral issues.
  • Document benefit and authorization information in the standard EMR screens and notes as needed.
  • Implement system downtime procedures when necessary.
    Requirements:
  • High School Diploma or GED required
  • 1 or more years of experience in hospital Patient Access required
  • Verbal and written communication
  • Customer service orientation
  • Basic math and PC proficiency
    Benefits:
  • PTO
  • 401(k)
  • Medical and dental plans

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