Insurance Verification Specialist II

Job Description

Job Description

1. Always maintains a presence at the front desk with the exception of break and lunch. Greet all patients / clients / visitors in a pleasant and professional manner, determining the purpose of the visit and directing them to appropriate person or department(s).

2. Coordinate and schedule surgeries with the physician schedulers according to established policies and procedures, for both surgery centers including block releases / holds, network status, and requesting external reps as needed. Coordinate new patients for Arlington with Arlington PAR.

o Communicate and confirm with Anesthesia for both centers.

3. Enters patient demographics and secures and scans copy of insurance card(s) and driver’s license. Aids and directs patients as needed with the completion of necessary forms.

4. Confirms insurance eligibility and referral requirements and obtain facility quotes.

o Manage Authorization for all Interstim / PNE for BCBS

o Ensure authorization is obtained if required

o Upload and manage Aetna implant paperwork to My Insight

§ Call Aetna to see if precertification is required

5. Patients check in and provide patient or legal guardian of the Patient’s Bill of Rights and Responsibilities, Advance Directives, and Grievance Procedure.

6. Scans and indexes patient documents pre- and post-surgery.

7. Organizing and maintaining a filing system of all patient charts, including generating charts and pulling charts.

8. Inform patients of clinic delays and maintain communication with the clinical area to facilitate appropriate clinic flow.

9. Explains financial requirements (preoperatively) to the patients or responsible parties and collects copays, copayments and balances due as required.

o Manage spreadsheet of claims and patient balance / refunds

10. Provide financial billing information / options to patients.

11. Records and reconcile daily all monies collected at the front desk.

12. Promptly and professionally answers telephone calls. Routes calls and messages appropriately, offering voice mail, paging, or redirection of calls as needed.

13. Facilitates patient flow and communicates delays with patients and clinical staff.

14. Conduct pre-visit chart preparation, precertification and fax duties as assigned.

15. Follows all clinic policies on safety and security; maintains restricted areas by safeguarding keyless entry codes and computer system passwords in strict confidentiality.

16. Appropriately and courteously screen solicitors for relevance to organization needs

o Manage Intellicentrics for case reps..

17. Responsible for keeping the reception and patient waiting areas clean and organized.

18. Monitors medical office supplies and inventory needs, oversees and maintains office equipment.

19. Scheduling of daily lab pick-up for specimens

20. Maintains accuracy and productivity levels as established by department standards.

21. Performs, organizes, and streamlines operational tasks to reduce the potential for errors.

22. Always maintains patient safety and confidentiality by keeping patient charts in an inconspicuous location at the front desk; and keeps discussion of a patient’s procedure(s) to a tone discernable only to the patient / legal guardian.

23. All other duties as assigned by Practice Administrator or department supervisor.

Pay Range $21-24