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Staff Job Composite

Insurance Verification Representative

JOB DESCRIPTION

Job Summary: Under general direction, coordinates all financial aspects of patient visits and admissions, including insurance verification, pre-certification information, follow-up of third-party payment denials, and financial counseling.

CHARACTERISTIC JOB TASKS AND RESPONSIBILITIES
May include any and/or all of the following:

  1. Verifies insurance coverage for patient admissions; makes written and/or verbal inquiries to third party payers to verify insurance status and pre-certification status and to follow-up payment denials.
  2. Counsels patients or families regarding payment financial matters before or after discharge.
  3. Performs various clerical tasks to expedite the verification process, including documentation of guarantor information, patient information and protocols, and medical record reproduction.
  4. Participates in educational programs, in-service meetings, and workshops.
  5. Performs other duties as assigned.

KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS

  • Knowledge of medical terminology
  • Familiarity with contract interpretation
  • Interpersonal/human relations skills
  • Verbal and written communication skills
  • Accounting skills
  • Ability to operate computer and CRT
  • Ability to maintain confidentiality

MINIMUM QUALIFICATIONS
Education and experience equivalent to:

High school diploma or equivalent with additional related course work; supplemented with two (2) years related experience.

1035

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