Insurance Verif Auth Team

Chesapeake Regional Healthcare

  • Virginia Beach, Virginia
  • 30+ days ago

    Highlights

    Under direct and indirect supervision of the Billing/Insurance Manager and/or Executive Director/Outpatient Imaging Administrator, accurately and efficiently verify patient insurance benefits and obtain necessary authorizations and referrals for services rendered at MRI & CT Diagnostics. Works in a clean, well-lit medical facility; subject to electrical, chemical, magnetic, and radiant energy hazards; exposure to infectious disease and lifting hazards; must stoop and bend in the course of job performance.

    Numbers & Facts

    LocationVirginia Beach, Virginia
    Websitehttps://chesapeakeregional.com/careers

    Description

    Under direct and indirect supervision of the Billing/Insurance Manager and/or Executive Director/Outpatient Imaging Administrator, accurately and efficiently verify patient insurance benefits and obtain necessary authorizations and referrals for services rendered at MRI & CT Diagnostics. Confirm deductibles, co-payments, cost-shares, and patient responsibility in a polite and professional manner.

    Major Job Functions

    Training and Leading New Employees, to Include:

    • Phone etiquette

    • Navigating the patient system

    • Navigating websites for authorizations and benefits

    • Training in how to obtain authorizations and benefits

    • Calculating copays

    • Daily operations

    • Ensuring the employee is able to perform daily Insurance and Authorization job functions

    • Reporting to the manager on the new employee’s progress

    Secondary Job Functions

    These responsibilities are to be completed as needed and alongside training responsibilities:

    • Verify insurance coverage and benefits for all scheduled patients at least 24–48 hours in advance

    • Confirm accurate billing address of carrier and contact person when appropriate

    • Confirm patient demographics, referring physician information, and other chart information is accurate

    • On behalf of the referring physician, obtain authorization for services from the insurance company if required

    • Process patient and insurance carrier telephone calls

    • Contact patient and/or referring physician when insurance coverage cannot be verified

    • Notify patient of any co-payments, cost-shares, or deductibles

    • Communicate with Scheduling Department when authorization cannot be obtained

    • Communicate with the front desk regarding any special circumstances

    • Properly notate accounts of all communications with patients

    • Ensure that copies of all referrals, written authorizations, and authorization numbers are entered in the patient RIS record and provided to the billing department

    • Obtain necessary clinical records to facilitate obtaining authorization

    • Contact attorney, verify representation and billing address, date of accident or injury; instruct front desk personnel to obtain patient signature on lien letter

    • Review authorization letters for accuracy

    • Refer patients with special payment circumstances to management

    • Communicate changes in insurance company requirements with staff and management

    • Maintain the current exam board as well as the pending board

    Qualifications

    • High School Diploma

    • Previous healthcare experience preferred; courses in medical terminology preferred

    • Ability to operate copier, fax machine, and computer

    • Must have excellent organizational, communication, and interpersonal skills

    • Ability to set priorities and manage varying workload

    Specifications

    • Must be able to remain calm in stressful situations

    • Must display courtesy and empathy toward coworkers and physicians

    • Must be able to make sound judgments and execute appropriate actions based on knowledge of departmental policies and procedures

    • Must be discreet with confidential information and abide by corporate HIPAA policies

    • Must be able to move about freely; sits, stands, and walks intermittently during the day

    • Must possess sufficient visual and auditory acuity, and manual dexterity to perform tasks

    • Must attend mandatory practice training and departmental requirements annually

    • Works in a clean, well-lit medical facility; subject to electrical, chemical, magnetic, and radiant energy hazards; exposure to infectious disease and lifting hazards; must stoop and bend in the course of job performance

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