Riverside Health System

  • Insurance Verification Coordinator

    Location Name Riverside Accounting
    Department Insurance Verification
    Job ID
    2018-14049
    Category
    Administrative/Clerical
    Shift
    Days
  • Overview

    Works under the supervision of the Manager and Director. Effectively utilizes all specific computer systems including billing registration clinical imaging scheduling and others as required. Completes pre-registrations to include insurance verification for all patient types. The representative is responsible for the delivery of critical components of the revenue cycle understanding regulatory compliance maintaining patient safety through correct patient identification practices and providing excellent customer service. Ensures proper collection and/or notification of payment due for services to be rendered. Has full understanding of the requirements for in the RHS Charity program and self-pay processes network / out of network authorizations vs. no authorizations and medical necessity. Expertise in providing quotes calculating patient payments electronically posting patient payments and time of service collections. The representative should be knowledgeable to set up payment plans and help explain financial responsibility to the patient. Must have the ability to identify issues and report trends. Acts as a liaison between the Insurance Verification and physician offices other departments and insurance companies providing consistent and relevant detail on issues and trends. Utilizes systems and work queues to meet daily productivity and goals. Reviews account denials to determine root cause. Implements patient safety by properly identifying patients. Must demonstrate strong problem solving skills high attention to detail and an aptitude for learning. Responsible to follow established policies and procedures and meet rendering department criteria ensuring account completion prior to patient check in. Participates in orientation performance improvement processes and monthly staff meetings as required. Employees must communicate with patients timely and accurately in a clear and concise manner. Promotes teamwork and customer service by demonstrating positive interpersonal relations.

    Qualifications

    Education: High School Diploma or equivalent required.

     

    Experience: 2+ years experience in Revenue Cycle, business office setting /or College Degree and 1+ years experience required.

     

    Certification: Revenue Cycle Specific Certification preferred (Example: CHAA - Certified Healthcare Access Associate or CPAT - Certified Patient Accounting Technician).

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