Summary

Responsible for following appropriate procedures to verify patient eligibility, coordinate benefits, run test claims and determine patient coverage and financial responsibilities for services. Always represents EHN in a professional manner.

Supervisory Responsibilities

This position does not have supervisory responsibility but will assist with orientation and training of other practice employees.

Primary Duties and Responsibilities

• Ensure all benefits are checked prior to scheduled appointments.
• Perform insurance verification of benefit coverage on all the patient’s insurance plans for each service being provided.
• Obtain and document in system all information related to coinsurance, copay, deductibles, authorization requirements, etc.
• Create documentation required to service the patient per policy and payer guidelines.
• Determine patient’s estimated financial responsibility using insurance verification information and payer contracts and/or self-pay guidelines.
• Utilize insurance websites to verify insurance coverage and benefits.
• Contact patient to review coverage and make financial arrangements if necessary.
• Document findings in practice management system.
• Maintain security and confidentiality of all patient account information.
• Perform work in compliance with company policy, department procedures and regulatory requirements, including HIPPA.

Secondary Functions

• Other duties which may be necessary or desirable to serve the patient and support the success of the department or the company overall.

Education and/or Experience; Certificates, Licenses, and Registrations (Minimum Requirements)

• High school diploma or equivalent.
• Minimum of two (2) years of relevant experience preferred.
• An equivalent combination of education, experience and training that would provide the knowledge, skills and abilities required for the successful performance of the essential job duties.

Necessary Knowledge, Skills, and Abilities

• Knowledge of generally accepted office practices, procedures, and equipment.
• Ability to read and understand written and verbal communication.
• Computer literate with proficiency in Window’s based programs.
• Ability to operate standard office equipment including fax machine, copier, postage machine, printers and 10-key by touch.
• Ability to work cooperatively and interact in a professional and respectful manner with physicians, staff, vendors and patients at all times.
• Ability to communicate clearly and concisely, both orally and in writing.
• Detail oriented.
• Ability to maintain the highest degree of confidentiality.
• Knowledge of medical billing procedures, including CPT and ICD9 coding with familiarity with HCPC coding.

Physical Demands / Work Environment

• Majority of work is performed in a general office environment. Exposure to moderate levels of noise in a well-lit, well-ventilated, and moderately paced environment.
• This position requires manual/finger dexterity as necessary to perform daily job duties.
• Occasionally required to stand and/or walk for extended periods of time.
• Occasionally required to sit for extended periods of time.
• Occasionally required to reach with hands and arms; lift, push, pull and/or carry objects up to 20 pounds.
• Frequently required to sit for extended periods of time.
• Frequent and/or continuous talking.

Reasonable Accommodations

To perform this job successfully, an individual must be able to perform each essential function satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.