What are the responsibilities and job description for the Insurance Verifier position at Boulder City Hospital?
GENERAL PURPOSE:
The Insurance Verification Recorder is responsible for verifying insurance, benefits, and getting authorizations on patients coming in when we are not notified in advance of registration for certain types of services not considered emergency services. For emergency services, authorizations are obtained as soon as possible following requirements set by each company and following the Hospital policy.
ESSENTIAL FUNCTIONS:
Ability to lift, walk, carry and stand. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements are represented of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
DUTIES AND RESPONSIBILITIES:
1. Obtains copies of Admitting face sheets, insurance cards each day from prior day registrations for inpatients and observation patients.
2. Obtains a copy of the inpatient registry daily to check all inpatient accounts for benefits and authorizations, if needed. Bring any payment or deposit issues to Collector’s attention.
3. Obtains copies of the daily schedule for x-ray and outpatient surgery and the pre-admit surgery patient listings. If another patient type requires prior authorization, that listing could also be obtained.
4. Makes appropriate calls or faxes to insurance companies as it relates to authorizations and benefits in a timely manner to avoid any penalties that could be incurred by the Hospital, should timely notifications not take place.
5. If the authorization was required by the doctor’s office, then makes necessary calls to doctor’s offices to also obtain this information in a timely manner. (This could be done as a follow up to phone calls already made by Admitting to the doctor’s offices.)
6. Notifies the UR and Discharge Planning department of any UR issues and follow up that they may need to do by e-mail, phone, or fax.
7. May be asked to call patients at home to obtain required demographic and insurance information if the patient has never been seen before at Boulder City Hospital.
8. Do pre-admit paperwork and registrations, making the needed updates so that when patient arrive, all Admitting has to do is obtain their signature and collect co-payments or deductibles that were previously agreed upon.
9. If observation patients become inpatients, then notifies the review organizations or insurance companies of change in status, should an authorization now be required. The UR and Discharge Planning departments will also be notified.
10. Other duties as assigned.
SKILLS AND ABILITIES REQUIRED:
1. Must have knowledge of Medical and Insurance technology.
2. Must possess computer skills and knowledge of other office equipment required for this position.
3. Must have knowledge of Medicare, Medicaid, Worker’s Compensation, and PPO and HMO contracts as they relate to prior authorization requirements.
EDUCATION AND EXPERIENCE REQUIRED:
1. High School Graduate or equivalent.
2. Must have knowledge of ICD-9 Coding, hospital billing, Medicare, Medicaid, Worker’s Compensation and PPO and HMO contracts.
3. Must have one year of hospital experience.
Job Type: Full-time
Pay: $16.75 - $22.80 per hour
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Tuition reimbursement
- Vision insurance
Schedule:
- Monday to Friday
- Weekend availability
Education:
- High school or equivalent (Preferred)
Experience:
- Health Insurance Verification Occupations: 2 years (Required)
- Medical billing: 2 years (Preferred)
Work Location: One location