Insurance Verification Representative

3 weeks ago

Deerfield, United States SCA Health Full time

Insurance Verification Representative - Covenant High Plains Surgery Center JOB_DESCRIPTION.SHARE.HTML

CAROUSEL_PARAGRAPH

JOB_DESCRIPTION.SHARE.HTML
  • Lubbock, Texas
  • Covenant High Plains Surgery Center
  • Network Management
  • Regular
  • Full-time
  • 1
  • USD $17.00/Hr.
  • USD $21.00/Hr.
  • 33737
Job Description Overview

Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.

As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:

  • We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business.
  • We have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care.
  • We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
  • We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines.

The new SCA Health represents who we are today and where we are going-and the growing career opportunities for YOU.

Responsibilities

Insurance Verification:

  • Verify that sufficient information is available for accurate verification and eligibility. This step may require direct contact with the physician office and/or the patient.
  • Determine if a secondary insurance should be added to the patient account ensuring the appropriate payer is selected for Primary insurance.
  • Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain eligibility, benefits and/or pre-certs and authorization information.
  • Enter the patient insurance information into patient accounting system ensuring the selection is the appropriate payer and associated financial class.
  • When the patient's insurance is Out of Network notify the manager immediately. Follow the Policies and Procedures when accepting Out of Network payers.
  • SCA's goal for each patient's insurance verification is complete and accurate. The insurance verifier will document the findings in the patient account and will contact the patient with either estimated co-insurance, co-pay and or deductible amounts due on or before the date of service as applicable
  • The Insurance Verifier will call each patient as part of center compliance with CMS Conditions for Coverage guidelines in contacting patient's prior to the date of service to review, Physician Ownership, Advance Directives and Patient Rights.

Authorization:

  • Obtain authorizations from insurance companies/physician offices. Ensure complete and accurate information is entered into the patient accounting system and the procedure scheduled, date of service and facility name are on the authorization. Ensure the authorization has not expired.
  • Enter authorization into patient accounting system. Include the name/CPT codes effective date of the authorized procedures.
  • Ensure high cost implant/supply or equipment rental is included on authorization.
  • Check insurance company approved procedure lists/medical policies. If procedure is not payable, notify patient. If patient wants to proceed, obtain signature on Medicare ABN or other non-covered notification form.

Financial Orientation:

  • Calculate co-pay, and estimated co-insurance due from patients per the individual payer contract per the individual payer contract and plan as applicable.
  • Acceptance of in-network benefits for out-of-network payers must be pre-approved by SCA Compliance Dept.
  • Be familiar with individual payer guidelines and the process of collecting over the counter payments/deductibles/copay/co-insurance. Knowledge of payer contracts including Medicare, Medicaid and other government contracts and guidelines and workmen's compensation fee schedule.
  • Contact the patient and communicate the center financial policy
Qualifications
  • Bachelor's degree preferred but not required
  • Experience checking authorizations
  • Must be experienced with cpt codes
  • Detailed and able to work in a high production environment
  • Healthcare experience a must
  • Local or within driving distance
USD $17.00/Hr. USD $21.00/Hr.

PI731d14cac4b7-1832

  • Customer Service Representative

    6 days ago

    Deerfield Beach, United States Deboo Insurance Agency Inc Full time

    Job DescriptionJob DescriptionJoin Deboo Insurance Agency Inc, a customer-focused insurance agency dedicated to delivering exceptional service to our clients in Deerfield Beach, Florida. As a Customer Service Representative, you will be the frontline of our agency, providing support and guidance to our valuable customers. While we value in-person...

  • Customer Sales/Service Representative 440 or 220

    2 weeks ago

    Deerfield Beach, United States Deboo Insurance Agency Inc Full time

    Job DescriptionJob DescriptionAre you looking to grow? So are we!Deboo Insurance Agency Inc in Deerfield Beach, Florida, is looking for an enthusiastic, customer-driven, and knowledgeable person to join our team as a Full-Time Licensed Insurance Customer Service Representative. In this role you will provide exceptional customer service to our clients,...

  • Patient Registration Representative

    4 days ago

    Deerfield Beach, United States The University of Miami Full time

    Current Employees:If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.**$1,000 Sign-On Bonus**The Patient Access department has an...

  • Customer Service Representative

    3 days ago

    Deerfield Beach, United States U-Haul Full time

    Location: 801 S Andrews Ave, Pompano Beach, Florida 33069 United States of America Are you a people person? Do you love helping others? U-Haul is in search of friendly, motivated people for the position of Customer Service Representative. As a Customer Service Representative, you will work as part of a supportive team to be the face of U-Haul company's...

  • Insurance Operations Manager

    2 months ago

    Deerfield Beach, United States JM Family Enterprises Full time

    The Insurance Operations Manager position drives all aspects of the corporate insurance submission program placement, including the risk analysis, administration, and communication required throughout the process. This dynamic role works with risk owners and stakeholders to understand their business model, their risk tolerance, and related risk...

  • Regional Technical Services Representative

    3 weeks ago

    Deerfield Beach, United States Mapei S.p.A. Full time

    We are currently hiring for a remote based Regional Technical Services Representative. In this role you will be responsible to provide technical assistance and training, product claim investigation and sales support in an assigned sales region as wel Technical, Representative, Regional, Service, Training, Manufacturing, Retail, Insurance

  • Patient Access Representative 2

    4 days ago

    Deerfield Beach, United States The University of Miami Full time

    Current Employees:If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.**** $2,000 Sign On Bonus ****The Patient Access department has an...

  • Accounts Receivable Representative

    2 days ago

    Deerfield Beach, United States Roto-Rooter Services Company Full time

    Overview: If job security, top pay, excellent benefits, and career advancement representing a well-known national brand are what you're looking for, Roto-Rooter is the company for you. We take a lot of pride in being a great place to work, providing excellent pay and top benefits. **Responsibilities**: **Responsibilities**: - Secure payment of invoice. -...

  • Account Representative I

    5 days ago

    Deerfield, United States Accreditation Association for Ambulatory Health Care Full time

    About us: AAAHC advocates for the provision of high-quality health care through the development and adoption of nationally recognized standards. We provide a valuable survey experience founded on a peer-based, educational approach to onsite review. The AAAHC Certificate of Accreditation demonstrates an organization’s commitment to providing safe,...

  • Account Representative I

    3 days ago

    Deerfield, United States Accreditation Associati Full time

    Job DescriptionJob DescriptionAbout us:AAAHC advocates for the provision of high-quality health care through the development and adoption of nationally recognized standards. We provide a valuable survey experience founded on a peer-based, educational approach to onsite review. The AAAHC Certificate of Accreditation demonstrates an organization’s commitment...

  • Service Sales Representative

    2 weeks ago

    Deerfield Beach, United States Sciens Building Solutions Full time

    ** Service Sales Representative** **Job Category****:** Sales **Requisition Number****:** SERVI01256 Showing 1 location **Job Details** **Description** **POSITION SUMMARY** Sciens Building Solutions is seeking a Service Sales Representative for our fire safety & security business. The Sales Representatives focus will be on new opportunities via end-user...

  • Customer Service Representative

    4 days ago

    Deerfield Beach, United States Richelieu Hardware Full time

    **Company Overview** Richelieu is a North American market leader in the distribution, importation, and manufacturing of specialty hardware and complementary products for the kitchen and bath, storage and closet, home office, and commercial environments. Our extensive customer base includes cabinetmakers, furniture and kitchen manufacturers, residential and...

  • Medical receptionist MRI Center

    1 month ago

    Deerfield, United States Stand Up MRI of Deerfield LLC Full time

    Job DescriptionJob DescriptionFront office medical reception work. Answering phones, scheduling appointments, insurance verification along with other clerical work. Would like someone experienced working at a medical imaging (MRI) Center but would consider training the right candidate.Job Type: Full-time/Part timeSalary: $16.00 - $18.00 per hourBenefits: For...

  • Investment Services Client Representative

    2 weeks ago

    Deerfield, United States Kestra Financial Full time

    Here at David A. Marcus and Associates, Inc., we have been helping our clients protect their current wealth and create long-term financial plans for more than 35 years. In addition to providing clients with a well designed strategy to help them achieve their own goals, our firm also specializes in corporate benefits and estate planning. Being a "full...

  • Investment Services Client Representative

    1 month ago

    Deerfield, United States Kestra Financial Full time

    Here at David A. Marcus and Associates, Inc., we have been helping our clients protect their current wealth and create long-term financial plans for more than 35 years. In addition to providing clients with a well designed strategy to help them achieve their own goals, our firm also specializes in corporate benefits and estate planning. Being a "full...

  • Investment Services Client Representative

    2 months ago

    Deerfield, United States Kestra Financial Full time

    Here at David A. Marcus and Associates, Inc., we have been helping our clients protect their current wealth and create long-term financial plans for more than 35 years. In addition to providing clients with a well designed strategy to help them achieve their own goals, our firm also specializes in corporate benefits and estate planning. Being a "full...

  • Investment Services Client Representative

    1 month ago

    Deerfield, United States Kestra Financial Independent Advisor Full time

    Job DescriptionJob DescriptionHere at David A. Marcus and Associates, Inc., we have been helping our clients protect their current wealth and create long-term financial plans for more than 35 years. In addition to providing clients with a well designed strategy to help them achieve their own goals, our firm also specializes in corporate benefits and estate...

  • Regional Technical Services Representative

    5 days ago

    Deerfield Beach, United States MAPEI Corporation Full time

    We are currently hiring for a remote based Regional Technical Services Representative. In this role you will be responsible to provide technical assistance and training, product claim investigation and sales support in an assigned sales region as well as assist the Technical Services Department and R&D with various projects nationwide. This is a very...

  • Customer Service Representative

    3 days ago

    Deerfield Beach, United States Chris McCafferty - State Farm Agent Full time

    Job DescriptionJob DescriptionPosition OverviewState Farm Insurance Agent located in Deerfield Beach, FL is seeking an outgoing, career-oriented professional to join their team. As a State Farm team member for Chris McCafferty - State Farm Agent, you will build and develop customer relationships within the community to promote State Farm products including...

  • Customer Relations Representative

    4 days ago

    Deerfield Beach, United States Chris McCafferty - State Farm Agent Full time

    Job DescriptionJob DescriptionBenefits:401(k)401(k) matchingCompetitive salaryHealth insuranceOpportunity for advancementPaid time offROLE DESCRIPTION:As a Customer Relations Representative - State Farm Agent Team Member with Chris McCafferty - State Farm Agent, you will generate the kind of exceptional client experiences that reinforce the growth of a...