Insurance Verification Rep I, Financial Clearance, Bolingbrook

Requisition ID: 48726

Location: Bolingbrook Corporate

Location Address:
1000 Remington Boulevard, Bolingbrook, IL  60440-5114 United States (US)

 

Daily Hours: 8
Standard Hours: 32
Employment Status: Part-time 
Employment Type: Regular 
Shift: Day
FLSA: N

 

SUMMARY

The Insurance Verification Representative I completes and coordinates pre-encounter insurance verification, pre-certification, payer authorization, financial clearance process and the associated seamless transfer to Patient Access ministry staff. Coordinates all in-house patient status changes and ensures payer requirements have been met to secure timely reimbursement and minimize payer denials.  Prioritizes, coordinates, and completes patient accounts; ensures all insurance requirements are met, secures payer authorizations, completes medical necessity screening and completes patient payment estimates. Ensures that all documentation is entered into applicable systems for site staff.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

  1. Performs insurance verification, pre-certification, payer authorization, calculation of patient estimated liability and assists with the financial clearance process to ensure that patient financial obligations are met prior to patient encounters for pre-scheduled patients; and during or post encounter for non-scheduled patients.

     

  2. Completes patient accounts based on departmental protocols, policies and procedures, and compliance with regulatory agencies, including insurance verification and payer authorizations in relation to pre-admission, admission, pre-registration and registration functions.

     

  3. Ensures all insurance requirements are met prior to patients’ arrival. Calculates and estimates patient charges and documents estimated patient financial liability (insurance limits and co-payment responsibilities) prior to arrival for services. 

     

  4. Records the appropriate information in information systems and completes daily weekly and monthly reports as required.

     

  5. Facilitates communication between Patient Access Services, physicians, external entities and other departments regarding insurance and payment issues.

 

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Education and/or Experience  

High school graduate or GED.

Previous experience in hospital admissions, business and/or physician’s office preferred. Knowledge of medical terminology preferred.

 

Computer Skills          

Proficient in Microsoft Office software and patient accounting systems experience preferred.

 

Business Unit: Corporate (LRHC and LPH)

COMPANY OVERVIEW:

EOE of Minorities/Females/Vets/Disability

Company
Presence Health Network
Posted
03/26/2018
Type
Full time
Location
Bolingbrook, Illinois 60440-5114, US