Texas Health

Insurance Verification Specialist PRN

US-TX-Plano
Job ID
2017-4015
Type
Regular Part-Time
Category
Clerical Administrative
Regular Work Hours
80
Department
Insurance Verification [801]

Overview

Texas Health Center for Diagnostics & Surgery is a surgical hospital treating more than 18,000 patients annually through our surgery, pain management and imaging services.  Our mission is to improve the health and well-being of the people in the communities we serve.  We are committed to providing excellent service to our patients, and we believe excellence begins with our employees. Voted Best Places to Work by Modern Healthcare and as one of The Best Companies to Work for in Texas, THCDS has an exciting opportunity to add to our family. 

 

Responsibilities

Responsible for the insurance verification process between the hospital and insurance companies, federal agencies and third party payers.  Verifies all patients who present for service, calculates the up-front cash amount which is collected at time of registration.  Participates in performance improvement and continuous quality improvement (CQI) activities. 

 

  • Contact the insurance companies, government agencies and third party payers to verify patient benefits, deductibles, co-pays and out of pocket amounts that are due at the time of registration at least four days prior to service if scheduling permits.  When four day margin is not reached, an average of 2.0 accounts per hour must be maintained as recorded on the employees productivity sheets.
  • Pre-certify the patient’s stay if required as needed.  Obtaining pre-certification must begin at least four days prior to the date of service.  Insurance Specialist must pending status to physician’s office two days prior to date of service.
  • Notify patients of the amount to be paid at admission while simultaneously attempting to reduce the anxieties of the patient.  Create and approve payment arrangements not to exceed three months, review payment options with patients and availability of financial assistance.  Insurance Specialist must have the ability to kindly, professionally, and accurately, and explain benefits plans to patients when asked.
  • Works as part of a team within the department and maintains professional peer relationships that promote inner department communication.
  • Communicates to the Insurance Verification Lead those accounts that need special handling or financial arrangements beyond guidelines and procedures.
  • Documents all correspondence and conversations with insurance companies, governmental agencies, third party payers and patients on patient's account on the day the communication took place.
  • Demonstrates the ability to be flexible, organized and function well in stressful situations.
  • Other duties as assigned

Qualifications

  • HS Diploma or equivalent
  • 3 or more years experience in interpreting and applying insurance benefit plans in the healthcare industry.  Previous insurance billing or claims review experience required.  Non-healthcare experience in this area may be considered if other requirements are met.

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