Insurance Verification Representative

Health insurance research, verification and documentation is not for the faint of heart. It can be a confusing field with as many different situations as there are patients. If you’re good at figuring out the details, chasing down the right people, and coordinating documents – we have a position that needs your skills. This is a specialized coordinating position with a mission: helping patients get the medical services they need.

WHO WE ARE

With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.

WHAT YOU CAN EXPECT

• Review clinical documentation in charts for accuracy and to obtain information updates regarding the verification process.

• Obtain and communicate information on patients' eligibility status with insurance companies, to ensure proper coverage and payment for services.

• Use Payor website, verbal communication, and other information to determine eligibility, reinstatement, and termination of Healthcare coverage.

• Collaborate with other departments within the hospital to align interdepartmental functioning, goals, and expectations, as related to insurance verification functions.

• Collect, analyze, and record all required demographic, insurance/financial, and clinical data necessary to verify patient information.

• Conduct follow-up with insurance carriers, physicians, and other stakeholders that can validate and assist with actions and information needed, to properly obtain authorizations.

• Document financial and pre-certification information, according to defined process, in a timely manner.

• Refer patients to Financial Counselors as needed to finalize payment for services.

• Request and coordinate financial verification and pre-certification as required to proceed with patient care; document financial and pre-certification information, according to defined process.

QUALIFICATIONS

• Preferred Associate's Degree

• Required High School Diploma/GED

• 2 years Revenue Cycle, collections, customer service or cash application. Preferred

• 1 year pre-cert experience, including navigating websites for online benefit review, coding or medical assistant background Required

• 1 year Medical and managed care contract terminology Preferred

• Medical Assistant Preferred

• Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) Preferred

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

Franciscan Alliance is committed to equal employment opportunity.

Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.