Insurance Verification Specialist - Home Health

Job Summary:

Responsible for verifying insurance coverage and eligibility of all patients' accessing services. Maintains confidentiality, professionalism, and ethics while assuring verification accuracy; pertaining to insurance coverage, demographics, and responsible party.

Job Responsibilities:

• Verifies coverage and eligibility in real-time for multiple departments throughout the organization.

• Verifies insurance coverage presented by the patients.

• Complete tasks that fall to the patient, claim edits, and account work queues.

• Communicates effectively with the community, professionals, insurance companies, and external agencies.

• Supports Case Management Staff for current patient issues.

• Communicates closely with financial advocates to resolve issues that require patient input.

• Resolves issues related to eligibility and coverage identified by billing staff to ensure claim payments.

• Participates in maintaining the payer database in EPIC.

• Supplies educators with examples of coverage discrepancies used to assist in the continued training of Access staff.

• Problem solves and troubleshoots system errors and reporting issues and/or routes to system administrators.

• Assists with special projects and duties as assigned.

• Performs all functions related to registration/admitting via computer.

Skills and Attributes:

• Requires critical thinking skills and decisive judgment.

• Works under general supervision.

• Must be able to work in a stressful environment and take appropriate action.

• Applies more advanced skills and knowledge in the area of specialization.

Position Requirements:

Work Experience

• No experience required

Education

• High school diploma, General Equivalency Diploma (GED) or higher required upon hire

Additional Education Information

• None

Licensure/Certification/Registration

• No licensure/certification/registration required

Organizational Responsibilities:

• Supports Owensboro Health’s Mission, Vision, Core Commitments, and business interests.  Adheres to all organizational policies and procedures. Executes all tasks and behaves in a manner consistent with a culture of compliance, safety and a high reliability organization.

Additional Job Information:

• This job description describes the general nature and level of work required by the position. It is not intended to be an all-inclusive list of qualifications, skills, duties, responsibilities or working conditions of the job. Specific duties and responsibilities consistent with the general nature and level of work described may vary by department and additional related duties may be assigned as needed. Some duties listed may not apply to all employees with this job description. 

• The job description is subject to change with or without notice, and Management reserves the right to add, modify or remove any qualification or duty. Nothing in this job description changes the existing at-will employment relationship between the Organization and the employee occupying the position.

Standard ADA Settings:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical Demands: (Office Environment)

Standing: Occasionally

Walking: Occasionally

Sitting: Frequently

Lifting 0-25 lbs.: Rarely

Lifting 25-75 lbs.: Rarely

Lifting over 75 lbs.: Rarely

Carrying 0-25 lbs.: Rarely

Carrying 25-75 lbs.: Rarely

Carrying over 75 lbs.: Rarely

Pushing/Pulling 0-25 lbs.: Frequently

Pushing/Pulling 25-75 lbs.: Rarely

Pushing/Pulling over 75 lbs.: Rarely

Climbing: Rarely

Bending/Stooping: Rarely

Kneeling: Rarely

Crouching/Crawling: Rarely

Reaching: Occasionally

Talking: Frequently

Hearing: Frequently

Repetitive Foot/Leg Movements: Rarely

Repetitive Hand/Arm Movements: Frequently

Keyboard Data Entry: Frequently

Running: Rarely

Vision: Depth Perception: Frequently

Vision: Distinguish Color: Frequently

Vision: Seeing Far: Frequently

Vision: Seeing Near: Frequently

Hazardous Drug Risk Exposure: No risk

Owensboro Health Core Commitments

INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers.

RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community.

TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future.

INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health.

SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do.

EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service.