Patient Benefit Coordinator ? Pain Clinic / Full Time / days

Elevate your career at Wood County Hospital, where you're not just a number – you're a vital part of a team making a real difference.

Patient Benefit Coordinator ? Pain Clinic / Full Time / days

The patient benefits coordinator provides personal care and professional excellence by identifying and verifying insurance benefits and initiating precertification for inpatient, observation, OB care, and outpatient services requiring case management. Also assists the Financial Services division with data analysis, clerical support, quality control, and patient account maintenance duties.

Major Tasks, Duties And Responsibilities

• Obtain registration and scheduling documentation from appropriate ancillary departments as well as surgery. Verifies insurance eligibility of each registration / preregistration case. Makes corrections to insurance as needed. Contacts physician’s office for current insurance information if needed.
• Initiate contact with insurance companies and third-party payers for each case. Initiate precertification for any case that requires case management. Obtains supporting documentation as needed for procedure precertification.
• Document benefit information for each case, including contact name; deductible / coinsurance information; pre-existing exclusions; requirements for PCP referrals; and benefit payment limitations in the account notes and benefit verification form.
• Verifies eligibility for inpatient and observation cases requiring clinical contact on the part of the utilization review staff with the third party payer. Obtains clinical contact information for the UR nurse. Inputs admission into MCG.
• Professionally communicates with physicians, staff and patients regarding benefit information.
• Professionally communicates with physicians, staff, and patients to obtain supporting clinical information as requested by insurance companies to authorize services. Completes forms as required by insurance companies.
• Initiates appeals on precert denials within 30 days of notification, including supporting documentation.
• Monitors precert appeals on a regular basis, following up with the payer for status of
  
  

appeal. Provides additional documentation as needed.

• Provides ongoing support to the Financial Services division staff as needed for special projects or assisting during staff shortages. This includes working on reports as assigned; updating the information system with corrected information; monitoring medical record requests, etc.
• Stays current with insurance industry and government information as it affects insurance benefits and prior authorization requirements. Attends in-services, seminars as required.
  
  

Education, Training And Experience

High School Diploma

Benefit Summary

Join our team, and you’ll have access to a cutting-edge facility with state of the art technology. You’ll also interact with some of the region's top notch healthcare professionals. You’ll find plenty of opportunities to grow and advance your career.

We’ll Also Reward Your Hard Work With

• Great health, dental and vision plans
• Competitive wages
• Prescription drug coverage
• Flexible spending accounts
• Life insurance w/AD&D
• Generous short term and long term disability plans
• Employer-matched 403(b)
• Employer sponsored cash balance pension plan
• Vacation and Holiday time
• Generous tuition reimbursement
• And a lot more!