Newport News, Virginia
Hiring Range
$18.20 - $23.68/Hourly
Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs.
Overview
Responsible for verifying insurance eligibility and benefits, obtaining authorizations and providing patient estimates. Researches, follows-up and resolves open and pending authorizations in a timely manner. Monitors work queues, managing workload and completing accounts effectively.
What you will do
- Obtains, validates and updates insurance information in the database, verifying eligibility and benefits. Utilizes effective and professional communication with patients, physicians' offices, and staff.
- Calculates and provides patient estimates and financial obligations. Ensures collection and/or notification of payment due for services to be rendered. Provides information and resources for patients regarding RHS financial assistance and self-pay processes.
- Verifies and/or obtains the necessary referral, authorization, or pre-certification prior to services being provided as required by payer.
- Researches and obtains missing information from provider practices, providing timely notification of issues, denials, and/or need for peer to peer.
- Monitors work queues, managing workload and completing accounts in a timely manner; follows current department workflows, staying up to date on changes.
- Utilizes Riverside Care Difference principles in all interactions and maintains strict confidentiality in all matters relating to PHI.
- Identifies issues and trends related to pending/denied authorizations, escalating to team lead and/or manager.
- Participates in continuing education and other learning experiences, sharing gained knowledge with team.
- Navigates online portals and systems to determine authorization requirements; catalogs and tracks authorization requests.
Qualifications
Education
- High School Diploma or GED, (Required)
Experience
- 1 year Revenue Cycle experience (Required)
Licenses and Certifications
- Certified Healthcare Access Associate (CHAA) - National Association of Healthcare Access Management (NAHAM) (Preferred)
To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.