Insurance Verifier/Collector

Surgery Partners Careers•Walnut Creek, CA

18d

About The Position

Insurance Verification & Authorization Verify patient eligibility, benefits, coverage limitations, deductibles, co-insurance, and out-of-pocket responsibilities prior to date of service. Obtain and validate prior authorizations and referrals in compliance with payer requirements. Identify and resolve coverage discrepancies prior to surgery to prevent denials. Communicate estimated patient financial responsibility clearly and professionally. Accurately document all verification and authorization details in the practice management system. Accounts Receivable & Insurance Follow-Up Manage assigned A/R buckets and maintain productivity standards. Follow up on unpaid, rejected, or denied claims in a timely manner. Submit appeals with appropriate documentation to resolve denials and underpayments. Review EOBs for accuracy and identify payment variances. Monitor timely filing limits and prioritize high-dollar accounts. Identify denial trends and escalate systemic payer issues to leadership. Benefits: Comprehensive health, dental, and vision insurance Health Savings Account with an employer contribution Life Insurance PTO 401(k) retirement plan with a company match And more! Equal Employment Opportunity & Work Force Diversity Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc. Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization.

Responsibilities

Verify patient eligibility, benefits, coverage limitations, deductibles, co-insurance, and out-of-pocket responsibilities prior to date of service.
Obtain and validate prior authorizations and referrals in compliance with payer requirements.
Identify and resolve coverage discrepancies prior to surgery to prevent denials.
Communicate estimated patient financial responsibility clearly and professionally.
Accurately document all verification and authorization details in the practice management system.
Manage assigned A/R buckets and maintain productivity standards.
Follow up on unpaid, rejected, or denied claims in a timely manner.
Submit appeals with appropriate documentation to resolve denials and underpayments.
Review EOBs for accuracy and identify payment variances.
Monitor timely filing limits and prioritize high-dollar accounts.
Identify denial trends and escalate systemic payer issues to leadership.