Insurance Verification Specialist

Company: Owensboro Medical Health System
Location: Owensboro
Posted on: May 8, 2022

Job Description:

Job Summary Responsible for verifying insurance coverage and eligibility of all patients# accessing services. Maintains confidentiality, professionalism, and ethics while assuring verification accuracy; pertaining to insurance coverage, demographics, and responsible party. # Job Responsibilities Verifies coverage and eligibility in real-time for multiple departments throughout the organization. Verifies insurance coverage presented by the patients. Complete tasks that fall to the patient, claim edits, and account work queues. Communicates effectively with the community, professionals, insurance companies, and external agencies. Supports Case Management Staff for current patient issues. Communicates closely with financial advocates to resolve issues that require patient input. Resolves issues related to eligibility and coverage identified by billing staff to ensure claim payments. Participates in maintaining the payer database in EPIC. Supplies educators with examples of coverage discrepancies used to assist in the continued training of Access staff. Problem solves and troubleshoots system errors and reporting issues and/or routes to system administrators. Assists with special projects and duties as assigned. Performs all functions related to registration/admitting via computer. Qualifications High school diploma, General Equivalency Diploma (GED) or higher required upon hire No experience required No licensure/certification/registration required Skills and Attributes Requires critical thinking skills and decisive judgment. Works under minimal supervision. Must be able to work in a stressful environment and take appropriate action. Knowledge in Medical Terminology and Medical Insurance. Physical Demands Standing: Occasionally Walking: Occasionally Sitting: Frequently Lifting 0-25 lbs: Rarely Lifting 25-75 lbs: Never Lifting over 75 lbs: Never Carrying 0-25 lbs: Rarely Carrying 25-75 lbs: Never Carrying over 75 lbs: Never Pushing/Pulling 0-25 lbs: Rarely Pushing/Pulling 25-75 lbs: Never Pushing/Pulling over 75 lbs: Never Climbing: Rarely Bending/Stooping: Rarely Kneeling: Rarely Crouching/Crawling: Rarely Reaching: Occasionally Talking: Frequently Hearing: Occasionally Repetitive Foot/Leg Movements: Never Repetitive Hand/Arm Movements: Frequently Keyboard Data Entry: Frequently Running: Never Vision: Depth Perception: Frequently Vision: Distinguish Color: Frequently Vision: Seeing Far: Frequently Vision: Seeing Near: Frequently Owensboro Health Core Commitments INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers. RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community. TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future. INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health. SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do. EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service.
Job Summary
Responsible for verifying insurance coverage and eligibility of all patients' accessing services. Maintains confidentiality, professionalism, and ethics while assuring verification accuracy; pertaining to insurance coverage, demographics, and responsible party.
Job Responsibilities

• 
  
• Verifies coverage and eligibility in real-time for multiple departments throughout the organization.
  
• Verifies insurance coverage presented by the patients.
  
• Complete tasks that fall to the patient, claim edits, and account work queues.
  
• Communicates effectively with the community, professionals, insurance companies, and external agencies.
  
• Supports Case Management Staff for current patient issues.
  
• Communicates closely with financial advocates to resolve issues that require patient input.
  
• Resolves issues related to eligibility and coverage identified by billing staff to ensure claim payments.
  
• Participates in maintaining the payer database in EPIC.
  
• Supplies educators with examples of coverage discrepancies used to assist in the continued training of Access staff.
  
• Problem solves and troubleshoots system errors and reporting issues and/or routes to system administrators.
  
• Assists with special projects and duties as assigned.
  
• Performs all functions related to registration/admitting via computer.
  
  Qualifications
  
  • 
    
  • High school diploma, General Equivalency Diploma (GED) or higher required upon hire
    
  • No experience required
    
  • No licensure/certification/registration required
    
    Skills and Attributes
    
    • 
      
    • Requires critical thinking skills and decisive judgment.
      
    • Works under minimal supervision.
      
    • Must be able to work in a stressful environment and take appropriate action.
      
    • Knowledge in Medical Terminology and Medical Insurance.
      
      Physical Demands
      
      • 
        
      • Standing: Occasionally
        
      • Walking: Occasionally
        
      • Sitting: Frequently
        
      • Lifting 0-25 lbs: Rarely
        
      • Lifting 25-75 lbs: Never
        
      • Lifting over 75 lbs: Never
        
      • Carrying 0-25 lbs: Rarely
        
      • Carrying 25-75 lbs: Never
        
      • Carrying over 75 lbs: Never
        
      • Pushing/Pulling 0-25 lbs: Rarely
        
      • Pushing/Pulling 25-75 lbs: Never
        
      • Pushing/Pulling over 75 lbs: Never
        
      • Climbing: Rarely
        
      • Bending/Stooping: Rarely
        
      • Kneeling: Rarely
        
      • Crouching/Crawling: Rarely
        
      • Reaching: Occasionally
        
      • Talking: Frequently
        
      • Hearing: Occasionally
        
      • Repetitive Foot/Leg Movements: Never
        
      • Repetitive Hand/Arm Movements: Frequently
        
      • Keyboard Data Entry: Frequently
        
      • Running: Never
        
      • Vision: Depth Perception: Frequently
        
      • Vision: Distinguish Color: Frequently
        
      • Vision: Seeing Far: Frequently
        
      • Vision: Seeing Near: Frequently
        
        Owensboro Health Core Commitments
        INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers.
        RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community.
        TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future.
        INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health.
        SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do.
        EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service.

Keywords: Owensboro Medical Health System, Owensboro , Insurance Verification Specialist, Other , Owensboro, Kentucky