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Insurance Verification Clerk

Company: Methodist Hospital
Location: Pinehurst
Posted on: June 10, 2021

Job Description:

The Insurance Verification Clerk is responsible for answering calls, benefits verification, and pre-certification. Customer service should be provided that meets and exceeds internal and external customer expectations. All staff must practice high standards of performance and maintain superior customer service at all times for all responsibilities.Minimum QualificationsHigh school diploma or equivalent required2 years of previous medical office experience requiredWorking knowledge of MS Office applications which includes Outlook, Word, Excel, and Power Point requiredAbility to interface with the staff at the insurance carriers, HIM, and Business Office staff requiredAbility to read, write and understand documents, correspondence, and memos requiredAbility to effectively present information one-to-one and in group situations to customers, clients, and other employees in the organization requiredAbility to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form requiredCritical thinking skills requiredEffective PC skills requiredPreferred Qualifications2 years insurance verification/pre-certification experience or related experience preferred. Additional education and/or training will be considered in lieu of experiencePrevious collections experience preferredEssential FunctionsOrganizes and communicates conference calls for all active projects on the schedule determined by the Project ManagerAct as liaison between patient, physician office, and insurance company to assist patients with regards to financial responsibilityNotify all scheduled patients of their financial responsibility prior to their date of serviceVerify patient insurance eligibility and benefits using technology tools, the telephone and the internet to ensure compliance with the facilities policies and proceduresCoordinate with insurance providers and the physician office to obtain pre-authorizations. Document these findings as instructed.Obtain information for medical necessity determination and coordinate with the physician office if additional information is neededCommunicate with patients to obtain any missing information necessary to achieve financial clearancePerform Benefit verifications on all new patientsCross train as required to assist with overflow responsibilitiesExhibit flexibility in work schedules and assigned tasksMaintains minimal error rateMaintains productivity as requested by BOMMaintains supplies and forms necessary to perform dutiesObtains and verifies patient demographic and financial informationParticipates in group meetings and /or various committeesMakes suggestions on workflow improvementsNotifies BOM of any issuesMaintains a positive attitude toward their position and responsibilitiesPhysical DemandsThe 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.While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus.The employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a regular basis.The employee must be able to stand and/or walk at least five hours per day.Work EnvironmentThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Keywords: Methodist Hospital, Fayetteville , Insurance Verification Clerk, Other , Pinehurst, North Carolina

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