HCA, Hospital Corporation of America Insurance Verifier in Tucker, Georgia
The Ambulatory Surgery Division operates over 100 ambulatory surgery centers’ across the U.S. Ambulatory Surgery Centers (ASCs) perform surgeries that do not require hospital admission. They provide cost-effective services and a convenient environment. Procedures are performed in a fully equipped operating room and recovery is under the care of highly skilled nurses. Whether young or old or somewhere in between, patients and their families benefit from the comfortable environment ASCs have to offer. Surgeries performed include eye, ear, nose and throat (ENT), general surgery, gynecologic, plastic surgery, podiatry and orthopedics. Apply Now! Come Join our Team!
GENERAL SUMMARY OF DUTIES:Contributes to the company by verifying benefits for scheduled patients. The Insurance Verifier interacts with the Scheduler to obtain necessary patient information from physician’s offices. The Insurance Verifier also determines how much money to collect from the patient up front and what reimbursement is expected from the insurance company.
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
- Performs insurance pre-certification, verification, interviews patients prior to surgery, and documents information accordingly.
- Verifies all patient eligibility, authorizations, benefits, claim information with insurance companies, and 3rd party payers prior to surgery.
- Determines patient portions due, amounts to be billed, contractual discounts to be taken, or any other authorized discounts that may apply. Communicates this information with appropriate personnel for preparation of the pre-admission process.
- Identifies all patient accounts accurately based on what PPO, HMO, or other Managed Care Organizations the patient’s insurance plan might fall under.
- Contacts patients and provides updates on benefit verification information, requests additional information, insurance cards, and explains to the patient his or her financial responsibility such as co-pays, co-insurance, co-deductibles, at time of service.
- Accurately completes data entry necessary including authorizations and benefits as well as patient communication in the appropriate module of AdvantX.
- Makes financial arrangements after consulting with CBO Director/BOM when patient is unable to pay amounts due in full the day of surgery.
- Notifies CBO Director/BOM of any insurance carrier information changes.
- Maintains insurance plan request database; ensuring data is entered accurately and in a timely manner, as determined through facility processes.
KNOWLEDGE, SKILLS & ABILITIES:
- Organization – Proactively prioritizes needs and effectively manages resources and time.
- Communication – Communicates clearly, concisely, and professionally.
- Analytical Skills – Demonstrates ability to critically evaluate and appropriately act upon information.
- Customer Orientation –Maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
- Decision Making – Identifies issues, problems, and opportunities; compares data from different sources to draw conclusions; uses effective approaches for choosing a course of action or develops appropriate solutions; takes action that is consistent with available facts, constraints, and probable consequences.
- Contributing to Team Success – Actively participates as a member of the Center’s team to move the team toward the completion of goals.
- Policies & Procedures – Articulates knowledge and understanding of organizational policies, procedures, and systems.
- PC Skills – Demonstrates proficiency in Microsoft Office (Excel, Word, and Outlook) applications; knowledge of, or ability to learn, AdvantX – Accounts Receivable System, Smart, HOST and other systems as required. Demonstrates ability to type on PC keyboard.
Technical Skills – o Knowledge of surgical procedures/medical terminology.
o Knowledge of insurance companies and insurance plans, contracts, and co-pays. o Demonstrates an understanding of the facility policy regarding payment arrangements and upfront collections. *EDUCATION: *
One or more years of working experience in a healthcare environment performing clerical duties, business office functions, or billing duties in a hospital or physician practice setting required. CERTIFICATE/LICENSE:
Basic Life Support (BLS) may be required as per facility standard.
Title: Insurance Verifier
Location: Georgia-Tucker-Northlake Surgical Center
Requisition ID: 08617-2366