Primary Purpose: Verify appropriate personal demographic and financial information for the purposes of ensuring: maximal reimbursement for services rendered. Initiates on-line verification and/or makes phone contact with Insurance Carriers and Plan Administrators to verify patient benefits. Precerts all inpatient stays and high dollar outpatient services. Ensures authorization has been obtained for all scheduled and non-scheduled inpatient and high dollar outpatient procedures. Follows up on missing data or problem accounts. Documents complete and accurate data relating to all necessary eligibility, benefits and precertification information in appropriate LastWord database fields. Informs management of trends of incomplete data, registration issues, etc.
Knowledge and Skills:
Education: High school diploma, associate's degree preferred or equivalent combination education and experience.
Years of Experience: One to three years experience in Registration, Billing, Customer Service, or Managed Care Organization work environment.
Required Skills and Knowledge: Analytical skills. Computer Literacy - use of multiple systems LastWord, OfficeMed, Envoy, OMNI, HDS, IDX, QUADRIS, Florida Shared, Ability to use Internet Access and utilize third party payor systems for eligibility and verification. Knowledge of health insurance coverage and requirements and payor contracts. Excellent communication skills, problem solving ability to deal with customers who are often adversarial. Typing (minimum of 35 words per minute).
Equal Opportunity Employer–minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity