Insurance Verification Representative

Found in: Resume Library US A2 - 1 week ago

New Albany Indiana, United States SCA Health Full time
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.

Accountabilities / 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 

 

 

 

Min:
USD $19.00/Hr.

Max:
USD $22.00/Hr.

  • Insurance Verification

    1 week ago

    New York, United States Vitreous-Retina-Macula Consultants of New York PC Full time

    Job DescriptionJob DescriptionCreates and modifies authorizations and/or orders for new and existing Members in an accurate and timely matterInsurance Verification determine if Participating in net work or out of Network- confirmed Members Benefits for services being renderedResearches, troubleshoots, resolves authorization and/or order processing issues and...

  • Licensed Insurance Sales Representatives

    1 week ago

    New Albany, United States Taylormade Insurance Llc Full time

    Job DescriptionJob DescriptionCompany DescriptionSouthern Indiana area Allstate Agent is hiring an out-going, career oriented, sales professionals to join their teams as a Licensed Insurance Sales Representatives (Licensed Sales Producers)Job DescriptionAre you looking for a new opportunity to maximize your skills and help others? Working for an...

  • Insurance Branch Claims Representative

    Found in: Resume Library US A2 - 1 week ago

    Bedford, New Hampshire, United States Concord Group Insurance Full time

    The Branch Claims Representative investigates, evaluates, and determines the appropriate disposition of all types of claims arising out of the Company’s business. This job also provides service to agents, insureds, and others in the course of handling those claims to their conclusion. Work is performed under general...

  • Business Office Representative Clerk

    Found in: Resume Library US A2 - 2 weeks ago

    New Albany, Indiana, United States SCA Health Full time

    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...

  • Licensed Insurance Producer

    1 week ago

    New Orleans, United States Villa Insurance Agency Full time

    Job DescriptionJob DescriptionAdvance your career at - Brightway Insurance, Villa Agency!Brightway Insurance, Villa Agency is hiring multiple producers for specific markets in the Greater New Orleans area. Brightway Insurance is the fastest growing independent Property and Casualty Insurance agency with access to over 100 insurance carriers. Forbes has named...

  • PATIENT ACCESS REPRESENTATIVE

    Found in: Careerbuilder One Red US C2 - 16 hours ago

    Indiana, PA 15705, USA, United States Indiana Regional Medical Center Full time

    Competitive wages and benefits, community involvement, opportunities for career advancement, tuition reimbursement; these are some of the reasons why IRMC is a nationally recognized employer.Position Summary: Patient Access Service Representative is responsible for completing the inpatient and outpatient scheduling, registration and insurance verification...

  • Client Service Representative-NYC, NYC

    1 week ago

    New York, United States World Insurance As Full time

    **Job Posting *OPEN*** **Client Service Representative- NYC, New York** Scan With Your Phone To Apply! **Position Summary** * The Client Service Representative will play an integral role in driving our mission to deliver innovative and cost-effective employer solutions that meet and exceed our clients expectations. **Essential Duties and Responsibilities**...

  • Insurance Coordinator

    Found in: Resume Library US A2 - 1 week ago

    Mishawaka, Indiana, United States Premier Dentist Partners Full time

    Overview: As an Insurance Coordinator, you will play a pivotal role in ensuring smooth operations within the dental office by managing all aspects of dental insurance processing and patient billing. This position involves verifying insurance coverage, processing claims, and assisting patients with understanding their insurance...

  • IN-Indianapolis Insurance Agent

    Found in: Resume Library US A2 - 1 week ago

    Indianapolis, Indiana, United States AMERICAN SENIOR BENEFITS LLC Full time

    Overview: Who we are: American Senior Benefits is a hybrid sales organization offering the best opportunity in Insurance sales in the country, proudly representing over 220 of the top carriers.  Lack of name recognition, chargebacks, and your business being replaced can be in the rear-view window. Are you driven to do the very best for your clients every...

  • Bodily Injury Claims Representative

    Found in: Resume Library US A2 - 1 week ago

    Bedford, New Hampshire, United States Concord Group Insurance Full time

    This Branch Claims Representative handles bodily injury and general liability claims through their life-cycle including - but not limited to - investigation, evaluation and claim resolution. The purpose of this position is to provide service to agents, insureds and others to ensure claims resolve accurately and timely. Work is performed under general...

  • Sales Representative

    1 week ago

    Albany, United States First Media Services Full time

    Job DescriptionJob DescriptionFirst Media Services is a locally-owned, fast-growing media and digital company.  We work in a family-friendly environment with managers who will guide your success with in-house training and support.We offer excellent benefits, includingHealth InsuranceLife insuranceA 401k retirement savings planVacation timeand more!We're...

  • Insurance Verification Specialist

    1 week ago

    New York, United States PHYSICAL THERAPY OF THE BRONX P C Full time

    Job DescriptionJob DescriptionPhysical Therapy OfficeMon/Wed/Fri  8-2Tues/Thur       8-530Sometimes Saturdays

  • Fully Remote- Distribution

    Found in: Resume Library US A2 - 1 week ago

    Trenton, New Jersey, United States PostJobMatches By WorkStaff USA Staffing Agency LLC Full time

    PostJobMatches By WorkStaff USA is a leading staffing agency in the job placement industry, providing top-notch professionals to facilities across the country. Our team of experienced recruiters work together to match the best candidates with the right job opportunities. Today we are seeking a Fully Remote- Distribution Representative  for our client in...

  • Small Account Marketing Representative

    3 days ago

    Albany, United States Council Services Plus, Inc. Full time

    **Small Account Marketing Representative** **COUNCIL SERVICES PLUS, INC.** - Empowering Nonprofits with Tailored Insurance Solutions - **COMPANY** CS Plus is a dynamic insurance agency committed to supporting nonprofits in navigating the complexities of liability insurance and employee benefits. Our mission is to provide cost-effective insurance solutions...

  • Pre-Service Representative

    7 days ago

    Albany, United States Albany Medical Center Full time

    Department/Unit: HBD - Medicine Cardiology Work Shift: Day (United States of America) Salary Range: $18.00 - $23.79 Pre-Service Representative I is responsible for the initial touchpoint of our patient population to provide an exceptional patient experience with assisting in scheduling of services for our Hospital and Practice. This requires ability to work...

  • PATIENT REPRESENTATIVE

    Found in: Careerbuilder One Red US C2 - 15 hours ago

    NEW PRT RCHY, FL 34655, USA, United States Suncoast Women's Care Full time

    Job DescriptionWe currently have a need for a full-time candidate.An OB/GYN practice located in Trinity is seeking a full-time Patient Representative to perform various administrative duties. The position requires someone that thrives in a busy and energetic environment.Duties/Position:* Patient relations: making the connection with the patient and placing...

  • Pre-Service Representative

    6 days ago

    Albany, United States Albany Medical Center Full time

    Department/Unit: HBD - Medicine Cardiology Work Shift: Day (United States of America) Salary Range: $18.00 - $23.79 Pre-Service Representative I is responsible for the initial touchpoint of our patient population to provide an exceptional patient experience with assisting in scheduling of services for our Hospital and Practice. This requires ability to work...

  • Insurance Sales Agents

    Found in: beBee jobs US - 2 weeks ago

    New York, New York, United States World FinancialGroup Full time

    We are seeking a highly motivated and competitive Insurance Sales Representative to join our team and drive the expansion of our business.Your primary responsibility will be to proactively seek out and acquire new clients, understanding their specific insurance needs and offering tailored solutions.By building strong relationships, your aim will be to...

  • Life Insurance Sales Representative

    1 week ago

    New Hope, United States Barnes Agency Full time

    Job DescriptionJob DescriptionJob Title: Account ManagerCompany Overview: Join our dynamic and rapidly growing team at the Barnes Family Agency, a leading provider of comprehensive life insurance solutions. We are committed to safeguarding our clients' financial futures and providing them with peace of mind through personalized life insurance plans. As...

  • Construction Control Representative

    6 days ago

    Albany, United States US Veterans Health Administration Full time

    **Duties**: Duties include but are not limited to: - Participates in design review conferences, reviews preliminary plans and specifications prior to advertisement for practicability, anticipated physical obstructions and other construction difficulties and availability of selected materials. - Attends and participates in pre bid conferences to orient and...