- Processes inbound and outbound calls for precertification of insurance benefits including confirmation of coverage being active or inactive, allowable coverages and creating the patient estimate, as needed.
- Provides physician practices, patients, and ancillary department insurance verification services for outpatient procedures provided by McLeod Health.
- Supports the Insurance Verification Supervisor with special projects, as needed.
- Partners and supports all 8 locations as well as the ancillary departments. This also includes partnering with all MPA (McLeod Physician Associates) practices as well as non-McLeod owned practices.
- Utilizing all tools and resources furnished via authorization/payer grids and payer portals and proactively, completes the patients work listed. This includes daily utilization of Microsoft Outlook and Teams.
- Comprehensively documents each patient’s encounter detailing the insurance verification portion thereby ensuring hospital reimbursement and reductions in patient wait times or likelihood of rescheduling.
- Ensures all patients are worked timely and there are no patients pending for next day at the close of business.
- Works to ensure all patients have been financially vetted with all worklists 3 days out or greater.
- Proactively notifies the Insurance Verification Supervisor if new payer information and/or updates are identified.
- Maintains a professional image and exhibits excellent customer relations to patients, visitors, physicians, and co-workers in accordance with our Service Excellence Standards and Core Values.
- Strong knowledge and experience with the overall insurance verification process including payer requirements
- Knowledge with the Revenue Cycle Process and the impact of this role
- Experience with Windows based computers and Microsoft Office
- Strong written and oral communication skills with persons of all ages and diverse backgrounds
Minimum of a High School diploma or equivalent from an accredited school required
Florence, SC, United States