Catholic Health Initiatives Insurance Verification Representative in LEXINGTON, Kentucky

Insurance Verification Representative

Description

  1. Job Summary / Job Purpose

Under general supervision, Insurance Verification Specialist is responsible for verifying patient’s insurance information and obtains authorization prior to scheduled visits in accordance with HIPAA guidelines, internal standards and procedures, and other regulatory requirements. Responsible for interpreting coverage limitations, patient versus insurance coverage, follows up with payors/patients to secure account and responds to insurance verification questions. Work closely with physicians, patients, and other healthcare staffs to ensure authorizations cover the services needed and that correct information is obtained.

  1. Key Responsibilities

+ Ensures insurance coverage by telephone.

  • Resolves any issues with coverage and escalates complicated issues to manager.

  • Interviews patients and completes all paperwork necessary to ensure the admitting process is efficient and all clinic and regulatory policies are in compliance.

  • Coordinates with clinical staff to obtain charge information for all patients.

  • Codes procedures performed and diagnosis on charge.

  • Assigns appropriate ICD-9, CPT and HCPCS code(s) to accurately support the need and documentation for each service.

  • Coordinate copies of medical documentation with physician charges to support billing to third-party payers.

  • Identifies physician services provided, but not accurately documented in the medical record.

  • Resolves routine patient billing inquiries and problems.

  • Performs other duties as assigned.

Qualifications

  1. Job Requirements / Qualifications

  2. Education / Accreditation / Licensure (required & preferred):

  • Bachelor’s degree preferred

1. Experience (required and preferred):

  • 2-4 years of healthcare experience preferred

Job Administrative/Clerical

Primary Location KENTUCKY-LEXINGTON-WOMENS CARDIOLOGY

Daily Schedule 1

Scheduled Hours per 2-week Pay Period 80

Weekends Required None

Req ID: 2018-R0158919