Georgetown Surgery Center - Patient Benefits Coordinator

About Georgetown Surgery Center

At Georgetown Surgery Center, excellence meets compassion in the realm of healthcare. We take pride in offering a diverse array of surgical specialties designed to cater to your unique healthcare needs. Our multi-specialty team comprises dedicated experts, committed to delivering outstanding care and tailored solutions across a wide spectrum of surgical disciplines.

From gastroenterology, orthopedics, general surgery, spine surgery, pain management, ENT, and specialized procedures for hand, foot, and ankle conditions, we provide comprehensive services under one roof. Our specialized Total Joint Program for knees, hips, and shoulders reflects our commitment to offering the highest quality care for your mobility and well-being.

At Georgetown Surgery Center, patient-centered care is not just a philosophy; it’s our guiding principle. We understand the importance of listening to your unique healthcare needs and collaborating closely with you to create personalized treatment plans. Our approach is characterized by empathy, understanding, and a dedication to ensuring your health and well-being.

About Regent Surgical Health

Since 2001, Regent Surgical Health has been a leader in developing and managing successful surgery center partnerships between hospitals and physicians. We continually improve and evolve the ASC model based on changing market conditions to stay ahead of emerging trends. From this vantage point, our team has developed proprietary ASC ownership models that give both physicians and hospitals what they need to ensure long-term clinical and financial success.

Position Summary

Under the direction of the Business Office Manager, the Insurance Verification Specialist ensures patients have valid and adequate insurance coverage for surgical services. They verify patient information, insurance eligibility and benefits, and authorizations and referrals before treatment including communication regarding financial responsibilities. This role requires strong communication with patients and physicians’ offices, attention to detail, and knowledge of healthcare insurance plans and billing procedures.

This is a full-time position. The center is open Monday - Fridays. No calls; No weekends; Holidays Off!

Duties/Responsibilities

• Verify insurance coverage by confirming patient’s insurance eligibility and benefits with various providers (HMOs, PPOs, Medicare, and Medicaid); document and update patient insurance details in the system and maintain up-to-date records.
• Investigate and resolve discrepancies in insurance information attached to patient account.
• Ensure valid authorizations were received from physician’s office for the scheduled procedure; confirm by contacting insurance companies and contacting physician’s offices in the event of missing authorizations.
• Communicate coverage details, and financial estimates to patients prior to services rendered; obtain payments for procedures; address insurance-related inquiries.
• Collect any outstanding balances; inform revenue cycle when account has outstanding insurance balance.
• Document all necessary information to the billing department for accurate claims processing.
• Adhere to HIPAA and other relevant regulations.
• Understand and apply ICD-10, CPT, and HCPCS codes when verifying coverage.
• Remain current on all case verification; standard operating procedure is two weeks prior to date of service.
• Notify the Business Office Manager in the event of insurance or authorization discrepancies or balances due.
• Run daily reports to ensure all cases are verified, authorized, and financial counseling is complete.
• Perform other duties as assigned.
  
  

Required

EDUCATION/EXPERIENCE

• High school diploma or equivalent
• Insurance verification or billing experience in a healthcare environment
• BLS certification (as required by individual ASC policy)
  
  

Preferred

• Two years of insurance verification or billing experience in a healthcare environment