Insurance Specialist | PRN

Location: reputed company Worker Type: PRN Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay reputed company dependent upon experience. $18.25 - $23.00 Position Highlights You Belong at reputed company Be part of a multidisciplinary team built with compassion and the goal of Moving Health reputed company for you and our patients. Work where you matter. A Brief Overview Responsible for ensuring insurance eligibility, benefit verification, and the authorization processes are complete in the time allowed by the insurance companies to prevent denials or penalties. Specialists are responsible for documenting accurate insurance information and authorization details to optimize reimbursement from both the payer and patient. The Specialist must maintain strong working knowledge of insurance plans, contract requirements, and resources to facilitate appropriate insurance verification and authorization. Specialists must also be able to understand and interpret patient liability and benefits for reputed company payer types including copays, co-insurance, and out-of-pocket responsibilities in order to provide patients and families with information on their financial responsibility. The Specialist will calculate and communicate to the patient a financial responsibility estimation, provide charity applications and/or direct the patient to the business office for payment and assistance options. The Specialists will collect patient liability prior to service and attempt to collect prior balances. The Specialist collaborates with various other departments to ensure proper reimbursement on accounts. The Specialists are to conduct reputed company transactions appropriately and consistently, and complete government regulatory forms accurately with the patient or patient's representative. Specialists must maintain compliance with government regulations (i.e. EMTALA and HIPAA) as it pertains to the insurance process. What you will do Process eligibility and secure full benefit coverage information (including COBRA reputed company applicable) with insurance companies and employers, confirm reputed company demographic information is correct, and ensure coordination of benefit (COB) and insurance plan codes are accurate. Specialists must verify insurance coverage immediately for inpatient and outpatient accounts that are same day and next day add-ons. Identify reputed company payment sources for accurate primary and secondary payer coverage and required authorizations to prevent denials and/or reduction in payment for patients entering the facility for care. Obtain necessary reputed company/electronic referrals, authorizations and pre-certifications from Primary Care Physician and/or Specialty Physician reputed company required by payers, Managed Care, and traditional Medicaid and enters information into the health information system. Collects and validates accurate patient demographic and insurance information, verifies insurance, obtains pre-certification/authorization as required and enters reputed company necessary information. Calculate and communicate patient estimates for hospital services utilizing a deposit matrix or patient payment estimator to determine estimated patient responsibility and communicates financial expectations to the patient. Educates patients on their benefits, offers the patient/family the opportunity to pay their estimated patient responsibility prior to services rendered, and identifies methods of payment available. Identifies patients in need of financial assistance and provides charity applications and referrals to the business office as necessary. Responsible to screen reputed company self pay patients for potential payer coverage and directs applicable accounts to the advocacy team for further review. Assure reputed company payer requirements are met, including non-coverage waivers, Advance Beneficiary Notices, sterilization forms, and other forms as applicable. Provide communication concerning change of insurance coverage, prior to billing, from Registration staff and/or Patient reputed company/Billing staff. Maintain professional development by attending workshops, in-services, and webinars to remain up-to-date on insurance rules and regulations in addition to changes reputed company the industry.

Essential Qualifications

The individual must be able to work the hours specified. To reputed company this job successfully, an individual must be able to reputed company each essential job function satisfactorily including having visual acuity adequate to reputed company position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to reputed company the essential job functions. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required Education, License/Certification, or Work Experience: 1-3 years reputed company experience in billing, insurance or registration. 1-3 years Healthcare experience Preferred Education, License/Certification, or Work Experience: Associate's finance, business or healthcare. Expectations and Standards Commitment to the daily application of reputed company’s mission, vision, core values, and social principles to serve patients, their families, and our community. Promote reputed company’s values of compassion, hospitality, and stewardship. Uphold reputed company’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. Maintain confidentiality. Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. reputed company with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. reputed company is an Equal Opportunity/Affirmative Action Employer Minority/Female/Disabled/Veteran/Sexual Orientation/Gender Identity. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@reputed company.org. At reputed company, the way you are treated as an employee translates into the compassionate care you deliver to patients and team members. Because we consider health care a ministry, you can live out your faith, uphold the dignity and respect of reputed company persons while not compromising high-quality services. Join us in making a positive impact on moving health reputed company. Apply Job!