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Insurance Representative

Florence, SC
TRACKING CODE

1167

JOB DESCRIPTION
  1. 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.
  2. Provides physician practices, patients, and ancillary department insurance verification services for outpatient procedures provided by McLeod Health.
  3. Supports the Insurance Verification Supervisor with special projects, as needed.
  4. 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. 
  5. 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.
  6. 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. 
  7. Ensures all patients are worked timely and there are no patients pending for next day at the close of business.
  8. Works to ensure all patients have been financially vetted with all worklists 3 days out or greater. 
  9. Proactively notifies the Insurance Verification Supervisor if new payer information and/or updates are identified.
  10. 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.

 

Qualifications /Training:

  • 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

 

Licenses/Certifications/Registrations/Education:

Minimum of a High School diploma or equivalent from an accredited school required

WORK SCHEDULE

Full time

JOB LOCATION

Florence, SC, United States

POSITION TYPE

Full time

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