Insurance Verifier-Houston Based Remote Position

Insurance Verifier - Houston Based Remote Position

Join to apply for the Insurance Verifier - Houston Based Remote Position role at Houston Eye Associates

Location : This is a Houston-based remote position.

Position Summary

The Insurance Verifier obtains necessary patient information from physicians' offices. The role involves determining the amount to collect from the patient upfront and estimating reimbursement from insurance companies.

Essential Duties & Responsibilities

• Verify insurance eligibility and benefits for specific CPT and diagnosis codes.
• Determine if physicians and facilities are credentialed with the plan via phone or provider website.
• Perform insurance pre-certification, verification, and document information while taking payments.
• Verify and obtain all patient eligibility, authorizations, benefits, and claim information with insurance companies and third-party payers within 3-5 business days prior to service.
• Determine and document patient financial responsibilities, including amounts due, billing, contractual discounts, and other authorized discounts.
• Communicate benefit verification information to appropriate personnel for pre-admission processing and address any issues.
• Identify patient accounts accurately based on insurance plans such as PPO, HMO, etc.
• Contact patients to provide benefit updates, request additional information, explain financial responsibilities, and collect insurance cards.
• Complete necessary data entry in the relevant systems, including authorizations and benefits.
• Arrange financial payments after consulting with Revenue Cycle Manager and / or Physician when patients cannot pay in full at the time of service.
• Document all information in PM System, EMR, and ASC PM.
• Notify Revenue Cycle Manager of any insurance carrier information changes.
• Attend meetings and participate in committees as needed.
• Perform other duties as assigned based on operational needs.

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Qualifications

Additional Details

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