Insurance Verifier
Posted on: 2 Jan 2021
North Dartmouth, MA
Job Description
Location: Steward Medical Group - North
Posted Date: 12/29/2020
Principal Duties and Responsibilities:
1. Verifies insurance benefits and obtains prior authorization for patient exams being performed at Hawthorn Medical/SMG. .
2. Records all insurance benefit and certification information in the applicable computer system. Completes and distributes all paperwork required by insurance and Imaging department.
3. Gathers all necessary information from secretaries to obtain pre-authorizations and pre-certifications as stipulated by each individual health plan for Diagnostic Imaging services and communicates with scheduling when additional information is required.
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4. Interfaces on a daily basis with insurance carriers, individual insurance provider authorizers, medical groups, and scheduling coordinators to maximize efficiency.
5. Follows company/department policies and procedures as well as compliance standards. Notifies management staff when problems arise.
6. When providing scheduling services, maintains communication with the ordering physicians and their secretaries to schedule patients for a variety of imaging procedures.
7. Knowledge regarding the appropriate exam preparation, appointment arrival time and contraindications. Able to communicate these instructions to both the scheduling secretaries and the patients that may call directly.
8. Utilizes payer websites to determine eligibility and benefit determination to ensure radiology exams are covered and to prevent denials.
Qualifications:
* High school diploma or equivalent required, associate's degree or Secretarial certificate preferred.
* Minimum of 2-4 years' experience in medical office setting required; medical terminology, and computer skills preferred.
Skills and Abilities Required:
Excellent customer service /communication skills.
Detailed knowledge of third party payer requirements for authorization requirements to facilitate payment for Imaging services.
Familiar with medical terminology, ICD-10 coding and CPT procedure codes preferred
Ability to process multiple tasks in an ever-changing environment and prioritize workload effectively. Must be able to function independently.
St. Joseph Medical Center
Houston, TX
Welcome to St. Joseph Medical Center (SJMC), Houston’s first and only downtown hospital. We have over 500 board certified physicians on our medical staff and more than 1,500 highly skilled and dedicated employees who stand ready to provide compassionate healthcare to the communities we serve.
Whether it’s for a scheduled surgery, the birth of a baby, an unexpected emergency, or an outpatient visit, we have staff available around the clock to provide you access to immediate, quality healthcare. SJMC has been providing healthcare services to Greater Houston residents for over 130 years, which should give you great comfort in knowing that we have a great tradition of caring for our community. We strive to meet our patients’ expectations and encourage our patients to provide us with feedback on how we can help them have the best experience possible while they’re in our care.
Over the years we have expanded our services to include the Advanced Wound Care Center, the Center for Behavioral Health, Comprehensive Cardiac and Vascular Services, the Women’s Center for Breast Care, the St. Joseph Maternal Fetal Medicine Center, and a Weight Loss Surgery Program, just to name a few. As you work with our physicians, nurses, case managers, educators, and other staff, you will be guided through your healthcare journey, from diagnosis to treatment, with compassion every step of the way.
As Houston’s first hospital, St. Joseph Medical Center partners with physicians to create a healthy environment of caring and dignity for patients, families, and employees. Focused on the latest technology and peer collaboration, we provide high value, high-quality care in an atmosphere of our spiritual traditions. We will remain the medical center that caregivers commit to, physicians prefer and patients recommend.
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IndustryHealthcare
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No. of Employees1,500+
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Website
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Jobs Posted1013
