Payor Verification Administrative Specialist

4 weeks ago

Dalton, United States Hamilton Health Care System Full time

JOB SUMMARY

Under the direct supervision of the Director, the Payor Verification Administrative Specialist verifies demographic and financial information. Verifies insurance coverage and obtains required authorizations, resolves pre-certification, registration, and case-related issues. Processes insurance pre-verification for hospital discharges and placements. Gathers pertinent information from patients, insurance carriers, financial counselors, and other staff to confirm the patient's obligations for services. Acts as a liaison between hospitals, clinical staff, health plans, providers, and patients to process referrals. Documents referrals, communications, actions, and other data in an information system. Generates and distributes all applicable forms, notifications, and paperwork. Seeks to help patients understand their financial responsibilities, giving the estimated out-of-pocket responsibilities and payment options; at all times providing first-class service to set the tone for the patient's journey of care as well as educate and manage the financial expectations for the patient prior to discharge. Provides administrative support to the case management team, prepares reports and other presentation materials utilizing word processing, spreadsheet, or specialized software. Maintains files or relevant records for the department, screens phone calls and responds or routes routine inquiries from internal and external sources with appropriate correspondence or other messaging. Schedules and coordinates meetings and other group activities. Manage office supplies or other routine processes.

Qualifications

JOB QUALIFICATIONS

Education:Completion of a high school diploma required. College level courses preferred.

Licensure: N/A

Experience:Prefer previous work experience in a position of meeting and communicating with the public. Prefer 1 to 2 years experience in a hospital billing office, medical billing office or other health care setting.

Skills:Excellent oral and written communication skills in order to effectively interact with internal and external customers. Knowledge of Medical Terminology and third party payer terminology. At least a minimal understanding of how CPT-4 and ICD-10 codes are used in health care billing. Intermediate proficiency in Microsoft Outlook, Word and Excel.

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