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Insurance Coverage Specialist

2 months ago

Natchitoches, Louisiana, United States Natchitoches Regional Medical Center Full time
Job Overview

Position Summary

The Insurance Coverage Specialist at Natchitoches Regional Medical Center is a proactive individual responsible for executing office tasks, assisting with billing processes, and conducting insurance verifications. This role entails confirming all insurance coverage for patient appointments, surgical procedures, and other medical services. The ideal candidate will demonstrate the ability to work independently and manage multiple tasks effectively in a dynamic environment influenced by patient volume. Upholding the mission and core values of Natchitoches Regional Medical Center is essential.

Key Responsibilities

Reasonable accommodations may be provided to enable individuals with disabilities to fulfill the primary responsibilities.

  1. Verify all insurance and workers' compensation benefits for scheduled outpatient services.
  2. Secure pre-certifications or prior authorizations for outpatient procedures, including Same Day Surgery.
  3. Obtain necessary PCP referrals mandated by third-party payers.
  4. Confirm eligibility for Medicare, Medicare HMOs, and Medicaid.
  5. Communicate with patients regarding their deductibles, co-pays, and payment arrangements.
  6. Document all relevant information from insurance providers in the patient's account and make necessary corrections.
  7. Ensure that the information displayed on the computer matches the details on insurance cards accurately.
  8. Assist with the patient registration process as needed.
  9. Provide insurance details to physicians upon request.
  10. Participate in staff meetings as required.
  11. Engage in emergency and disaster response situations.
  12. Perform miscellaneous duties as assigned by the supervisor.
  13. Maintain patient records in Caretracker.
  14. Conduct office billing using Caretracker.
  15. Ensure balanced tallies in all batches.
  16. Support other departments as necessary.
  17. Register patients into Meditech for lab or x-ray procedures when required.
  18. Manage inventory and order clerical supplies as needed.
  19. Cross-train to perform Receptionist duties.

Required Competencies

  1. Proficient in reading, writing, speaking, and understanding English (additional languages are a plus).
  2. Ability to maintain focus amidst frequent interruptions.
  3. Familiarity with third-party payers.
  4. Understanding of admission protocols.
  5. Knowledge of automated systems and basic computer applications.
  6. Typing speed of 50 words per minute.
  7. Capability to meet deadlines and manage time constraints.
  8. Discretion in handling confidential information.
  9. Effective telephone communication skills.
  10. Ability to interact with the public in a courteous manner.
  11. Attention to detail and ability to follow instructions and prioritize tasks.

Supervisory Responsibilities

This position does not have supervisory responsibilities.

Education and Experience Requirements

  1. High school diploma or GED is required.
  2. Minimum of one year of experience in admissions is required.

Preferred Qualifications

  1. Vocational training in office procedures is preferred.
  2. One to two years of college education is preferred.
  3. Six months of experience in a medical business office is preferred.
  4. Knowledge of medical terminology is preferred.
  5. Prior experience with insurance billing in a healthcare setting is preferred.