The Insurance Verification Clerk is responsible for answering calls, benefits verification, and pre-certification. Customer service should be provided that meets and exceeds internal and external customer expectations. All staff must practice high standards of performance and maintain superior customer service at all times for all responsibilities.

Minimum Qualifications

• High school diploma or equivalent required
• 2 years of previous medical office experience required
• Working knowledge of MS Office applications which includes Outlook, Word, Excel, and Power Point required
• Ability to interface with the staff at the insurance carriers, HIM, and Business Office staff required
• Ability to read, write and understand documents, correspondence, and memos required
• Ability to effectively present information one-to-one and in group situations to customers, clients, and other employees in the organization required
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form required
• Critical thinking skills required
• Effective PC skills required

Preferred Qualifications

• 2 years insurance verification/pre-certification experience or related experience preferred. Additional education and/or training will be considered in lieu of experience
• Previous collections experience preferred

Essential Functions

• Organizes and communicates conference calls for all active projects on the schedule determined by the Project Manager
• Act as liaison between patient, physician office, and insurance company to assist patients with regards to financial responsibility
• Notify all scheduled patients of their financial responsibility prior to their date of service
• Verify patient insurance eligibility and benefits using technology tools, the telephone and the internet to ensure compliance with the facilities policies and procedures
• Coordinate with insurance providers and the physician office to obtain pre-authorizations. Document these findings as instructed.
• Obtain information for medical necessity determination and coordinate with the physician office if additional information is needed
• Communicate with patients to obtain any missing information necessary to achieve financial clearance
• Perform Benefit verifications on all new patients
• Cross train as required to assist with overflow responsibilities
• Exhibit flexibility in work schedules and assigned tasks
• Maintains minimal error rate
• Maintains productivity as requested by BOM
• Maintains supplies and forms necessary to perform duties
• Obtains and verifies patient demographic and financial information
• Participates in group meetings and /or various committees
• Makes suggestions on workflow improvements
• Notifies BOM of any issues
• Maintains a positive attitude toward their position and responsibilities

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus.

The employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a regular basis.

The employee must be able to stand and/or walk at least five hours per day.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.