Responsible for accurate insurance verification for scheduled patients. Obtains referrals and/or prior authorization for scheduled patients.
1. Verifies insurance eligibility, obtains co-pay amounts, and medical/clinical authorization for case as needed.
2. Demonstrates knowledge of insurance payers and the use of electronic systems for verification purposes.
3. Enters demographic and billing information into EvergreenHealth systems.
4. Uses electronic systems and payer websites for verification of insurance, authorizations and referrals.
5. Responsible for working with physician's office to ensure authorization is in place prior to schedule service when required.
6. Follows EvergreenHealth's Financial Clearance Policy.
7. Obtains authorization or referral, as required, and enters into patient's encounters.
8. Identifies the need for financial counseling and refers patients to the Financial Counselor as needed.
9. May perform pre-registration of patient prior to scheduled appointment (may be conducted over phone or in person with patient or patient representative) in accordance to the department's pre-registration process.
10.Performs other duties as assigned.
License, Certification, Education or Experience:
REQUIRED for the position:
•High school diploma or equivalent
•Previous general office or administrative support experience
•Excellent communication skills to effectively obtain information from patients, physicians, and other team members.
•Numerical ability is required to discuss financial arrangements, to include determining coinsurance and deductibles.
•Ability to function independently, organize work, multitask and establish priorities.
•Ability to exercise good judgment in determining appropriate actions when problem solving, retaining composure in stressful situations.
DESIRED for the position:
•1 year experience in a hospital or medical setting
•Working knowledge of medical insurances
•Knowledge of medical terminology