Insurance Specialist

RIVERVIEW SURGICAL CENTER LLC•South Sioux City, NE

8d•Onsite

About The Position

Riverview Surgical Center is a multi-specialty surgery center committed to excellence through innovation and compassionate care. Our facility is equipped with cutting-edge technology to support everything from general surgery to outpatient joint replacements in a comfortable, modern setting. Our team is defined by a culture of care, where nursing staff, surgeons, and administrative professionals collaborate to provide a seamless, hassle-free experience for our community. We are looking for dedicated individuals to grow with us in our mission to provide exceptional, compassionate healthcare. RESPONSIBLE AND ACCOUNTABLE FOR: Verifying insurance coverage prior to patient arrival for evaluation and determining if the surgery center is in or out of network for patients. Completing insurance verification forms with correct benefit information, including deductible, co-pay and/or coinsurance. Providing estimates to patients on financial responsibility. Generate daily reports of evaluations to verify insurance is within network and obtaining referrals and prior authorizations from policies that require it. Answering patient phone calls promptly and addressing patient concerns. Obtaining proper insurance information and providing insurance information to patients. Serve as a backup for registration and scheduling. Comforts patients by anticipating patients’ anxieties; answering patients ‘questions; responsible for keeping the reception area clean and organized. Protects patient’s confidentiality, making sure protected health information is secured by not leaving PHI in plain sight and logging off the computer before leaving it unattended. Answers the phone while maintain a polite, consistent phone manner using proper telephone etiquette. Obtains revenue by recording and updating financial information; recording and collecting patient charges; controlling credit extended to patients with prior approval; filing, collecting, and expediting third- party claims.

Requirements

Must have high school diploma and or equivalent.
Working knowledge of insurance verification, benefits, prior authorization, medical necessity, and coordination of benefits.
Must be able to pay attention to details and accurately input data.
Must have knowledge but not limited to – medical terminology, Word, Excel, Outlook, PC, telephone skills, Customer Service, Time Management, Organization, Attention to Detail, Multi-tasking, Flexibility, and Professionalism.
Must be able to perform each essential duty satisfactorily.
Ability to read and interpret documents such as physician orders, safety rules, operating and technical instructions, and policy and procedures manuals.
Ability to create routine reports and correspondence.

Responsibilities

Verifying insurance coverage prior to patient arrival for evaluation and determining if the surgery center is in or out of network for patients.
Completing insurance verification forms with correct benefit information, including deductible, co-pay and/or coinsurance.
Providing estimates to patients on financial responsibility.
Generate daily reports of evaluations to verify insurance is within network and obtaining referrals and prior authorizations from policies that require it.
Answering patient phone calls promptly and addressing patient concerns.
Obtaining proper insurance information and providing insurance information to patients.
Serve as a backup for registration and scheduling.
Comforts patients by anticipating patients’ anxieties; answering patients ‘questions; responsible for keeping the reception area clean and organized.
Protects patient’s confidentiality, making sure protected health information is secured by not leaving PHI in plain sight and logging off the computer before leaving it unattended.
Answers the phone while maintain a polite, consistent phone manner using proper telephone etiquette.
Obtains revenue by recording and updating financial information; recording and collecting patient charges; controlling credit extended to patients with prior approval; filing, collecting, and expediting third- party claims.