Insurance Verifier Job Description
Insurance verifier
provides professional, accurate, and timely insurance verification for outpatient diagnostic services, observation and inpatient services.
Insurance Verifier Duties & Responsibilities
To write an effective insurance verifier job description, begin by listing detailed duties, responsibilities and expectations. We have included insurance verifier job description templates that you can modify and use.
Sample responsibilities for this position include:
Knowledge of computer programs including Sunport, Cerner, Medicare Compliance, & Galvanon (preferred)
Complexity of this position is evidenced by the use of simple and complex medical terminology and insurance verification protocols
Interviews self-pay patients to identify potential eligibility for government aid and / or other payer sources, including Medi-Cal / Medicaid presumptive eligibility
Investigates all inpatient admissions or surgical day registrations for insurance eligibility and authorizations and any other vital information needed to collect payment
Corresponds with third party carriers and/or patients to obtain insurance data
Verifies and inputs data into the Meditech computer system
Verifies insurance coverage using automated eligibility systems
Obtains auto liability information on auto accident cases including copies of the police report
Attends variety of meetings, conferences, and seminars as required or directed
Communicates with all customers (patients, families, staff, physicians, vendors, etc) in a helpful and courteous manner while extending exemplary customer service
Insurance Verifier Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Insurance Verifier
List any licenses or certifications required by the position: GOLD
Education for Insurance Verifier
Typically a job would require a certain level of education.
Employers hiring for the insurance verifier job most commonly would prefer for their future employee to have a relevant degree such as Associate and Bachelor's Degree in Education, Associates, Medical, Healthcare, Business/Administration, Communication, Government, General Education, Technical, Computer
Skills for Insurance Verifier
Desired skills for insurance verifier include:
Basic medical terminology
Medical terminology
Medical insurance/authorization process
Medi-Cal
Medicare
& Galvanon
Cerner
Collects on all opportunities
Inpatient and Outpatient pre-registration processes
Insurance plan requirements
Desired experience for insurance verifier includes:
Meets or exceeds accuracy standard goal determined by Pre-Access Leadership
Meets or exceeds upfront collection standard goal to protect financial standing of Florida Hospital
Accountable for maintaining a close working relationship with team mates, point of service registrars, departmental staff, physician’s offices
Perform pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services
Assign Iplans accurately
Perform electronic eligibility confirmation when applicable and document results
Insurance Verifier Examples
1
Insurance Verifier Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of insurance verifier. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for insurance verifier
- Corresponding with third party carriers and/or patients to obtain insurance data
- Verifying and inputting data into the Meditech computer system
- Verifying insurance coverage using automated eligibility systems
- Obtaining auto liability information on auto accident cases, including copies of the police report
- Complying with established departmental policies, procedures, and objectives
- Attending variety of meetings, conferences, and seminars, as required or directed
- Demonstrating use of quality improvement in daily operations
- Complying with all health and safety regulations and requirements
- Ensures that insurance pre-certification, authorizations and/or referrals are present prior to procedure
- Verify and obtain all patient eligibility, authorizations, benefits, and claim information with insurance companies per Best Practices
Qualifications for insurance verifier
- Calculates estimated patient responsibility based on scheduled procedures and insurance allowable per managed care grid
- In collaboration with materials management, accurately estimates implants and high cost supplies
- Prepares written estimates per patient or physician request
- Re-verifies benefits as necessary and when a discrepancy between original verification and adjudication is found
- Accurately profiles insurance in Accounts Receivables System to ensure claims are generated to the correct carrier
- Confirms completion and accuracy of patient and insurance information in order to generate clean claims
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Insurance Verifier Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of insurance verifier. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for insurance verifier
- Communicates with Doctor’s office staff any issues with patients such as difficulty reaching the patient or inability to make an acceptable Financial Arrangement
- Monitors and adheres to Local Coverage Determination (LCD) requirements payer specific medical policy requirements
- Verifies and obtains all patient eligibility, authorizations, benefits, claim information with insurance companies, and 3rd party payers at least within 3 business days prior to surgery
- Determines and documents accordingly patient portions due, amounts to be billed, contractual discounts to be taken, or any other authorized discounts that may apply
- Meets all educational requirements as stated in policy and as required by the CIA
- Compiles weekly/monthly statistics as needed for monitoring progress
- Has minimal direct contact with patients and patients’ families
- Position requires access to confidential information (financial, medical, census) in the Meditech system
- Update accounts in GPMS with information obtained through correspondence and telephone (ie
- Under the supervision of Supervisor, Patient Financial Services Operations the insurance verifier is responsible for ensuring that all outlined client scheduled accounts are verified and accounts are completed accordingly and may include any non-scheduled procedures such as add-ons, direct admits and transfers
Qualifications for insurance verifier
- The insurance verifier is responsible for making the telephonic process as pleasant as possible for all patients and their families additionally responsible for communicating payment policies and providing patient education as it relates to insurance benefits
- This position ensures coordination and communication between departments becoming a resource for the patient, physician, and facility
- The insurance verifier must accurately collect and input patient information into the database to ensure accurate billing and complete medical record attainment
- The insurance verifier functions includes preregistration, insurance selection, interpretation of insurance contracts, collaborating with Manage Care contracting on obtaining Letter of Agreements, gathering patient complex demographics, benefits collections, and authorizations for the CA region
- This position is responsible for the day to day operations of the department that verifies various types of insurance benefits from simple office visits to very complex surgical and medical procedures, securing authorization, notification for Inpatient and Outpatient surgery and Inpatient admissions for account information for reimbursement
- This position is also responsible for ensuring patient satisfaction as it relates to securing accounts prior to the patients arrival to the medical centers
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Insurance Verifier Job Description
Job Description Example
Our company is hiring for an insurance verifier. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for insurance verifier
- The insurance verifier displays professional interpersonal skills and presence when communicating with physicians, staff and the public
- It is essential that this information be documented timely and accurately
- Collects/receives patient demographic and financial information via phone, mail and/or Internet
- Reviews eligibility discrepancies
- Responds to verbal and written requests for patient financial information in compliance with HIPAA regulations
- Obtaining required referrals and authorizations prior to services via phone, fax, online
- Scans assignment of benefits, verification of benefit information and financial liability and forwards completed information back to the appropriate office
- Verifies insurance eligibility and benefits on all assigned accounts using electronic verification systems or by contacting payers directly to determine level of insurance coverage
- When appropriate, ensures the payer receives a Notice of Admission on all admissions, scheduled and non - scheduled, within 24 - hours or the next business day
- Follows up on missing authorizations
Qualifications for insurance verifier
- Typing speed of 30 wpm, operation of ten key adding machine/calculator
- Familiar with operating personal computer and knowledge of general clerical duties
- 1+ year Medical Hospital experience with working knowledge of insurance and business functions
- Strong experience in insurance verification and managed care contracts
- Typing and performing calculations at a level generally acquired through completion of high school
- Must have the math skills to calculate patient quotes based upon their benefits
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Insurance Verifier Job Description
Job Description Example
Our innovative and growing company is looking for an insurance verifier. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for insurance verifier
- When collecting patient payments, follows policy and procedure regarding applying payment to the patient’s account and providing a receipt for payment
- Works with physician offices and clinical areas to collect and share patient information, and to update these stakeholders on changes in patient registration requirements, processes and program
- Exercising a high degree of control over confidential medical informationInput, update insurance information
- Assist other departments with any copying, scanning, or other duties as applicable
- Ensure Admission Notification has been completed and verify insurance eligibility
- Identify services and payers requiring authorization, ensuring required authorizations are in place
- Ensure Motor Vehicle Accident, Workers Compensation or other Third Party Liability paperwork has been completed
- Process real time eligibility work queues and assigned denial work queues timely and accurately
- Maintain current knowledge of and competency with numerous Federal, State and other regulatory body compliance regulations and third-party insurance plans
- Use multiple computer applications to establish accounts and obtain verification information
Qualifications for insurance verifier
- Communication and interpersonal skills with a strong emphasis on telephone interviewing techniques
- Ability to work with stand alone or integrated health care computerized systems preferred
- Minimum 2 years experience hospital insurance verification required
- Must be able to follow directions and to perform work according to department standards when not directions are given
- Must be able to speak and write in a clear and concise manner in to convey messages and ensure the customer understands whether clinical or non-clinical
- High School Diploma with 2~3 years of related experience in Patient Access, billing, insurance company work or higher education with an emphasis in health services
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Insurance Verifier Job Description
Job Description Example
Our company is growing rapidly and is looking for an insurance verifier. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for insurance verifier
- Reviewing, documenting and distributing all faxes received through the S-Fax system throughout the day
- Obtaining previous requested referrals and authorizations via phone, fax, online
- Scanning authorization approvals, partial approvals or denials, into imagining in Intergy
- Informing the Clinical Appeals unit, verifier & your manager when a treatment or service is denied or partially denied
- Updating the patient account with details of the authorization/referral in the CIVU questionnaire
- Follow up on accounts that are listed as Unable to Request and completing the authorization or notifying the original requestor if necessary, when documents are available (Consult note, comparison or additional clinical) to assist with insurance verification/authorization process
- Follow up with the insurance company until valid authorization or denial is received
- Attending insurance meetings/online website trainings for payer updates and information as required
- Maintaining productivity of working 60 patient accounts daily
- Review reporting to identify missed authorizations which will be provided to the appropriate verifier or obtain the authorization/referral to ensure that it is obtained
Qualifications for insurance verifier
- Basic knowledge of patient accounting and insurance systems
- Basic knowledge of the requirements for patient scheduling and processing surgical procedures
- Claim information for worker's compensation claims
- Written, signed physician orders
- Demographics to include current home and work phone numbers
- Document multiple physicians for copy of exam report if appropriate