Insurance Authorization/Verification Clerk/Registrar

Insurance Authorization/Verification Clerk/RegistrarFull Time, M-F

Overview

Verifies insurance coverage and determines patient's financial responsibility. Reviews and confirms insurance authorization for all services as required. Determines patient qualifications for coverage. Completes pre-registration calls to patients verifying insurance and demographics. Admits and registers patients to the Hospital. Ensures excellent patient service, for patients and families, physicians and staff, and visitors to the Kansas Spine & Specialty Hospital. Upholds the mission statement and expectations of the facility.

Key Tasks & ResponsibilitiesEssential Functions

1. Verifies current eligibility for patient's date of service for all insurances to include worker's compensation, accident insurance and state programs. Verifies patient's specific benefits to include patient's remaining deductible and out-of-pocket to determine patient's financial responsibility, as applicable.
2. Confirms insurance authorization for services by obtaining precertification information from physician's office, verifies procedure, status and date of service accurately with insurance (on line, etc.) prior to date of service, as applicable.
3. Reviews Out-Of-Network Insurance Plans for In-Network vs. Out-Of-Network benefits and provides calculation of estimated charges, cost and payment to Patient Accounts Manager and/or CFO to make a financial determination for approval to perform service.
4. Documents and scans insurance eligibility and authorization prequalification for all payer's before date of scheduled admission.
5. Provides charge estimates and cost of implants for all procedures, upon request.
6. Completes Pre-registration calls by verifying patient demographic and insurance information, informing patient of financial responsibility and initiating scripting as directed.
7. Negotiates and collects point of service payments with timely notification to patient prior to service (i.e. copays, deductibles, self-pay rates).
8. Provides exemplary customer service by immediately greeting patient with courteous smile, introducing self and providing a quick, proficient and accurate registration.
9. Communicates effectively and works cooperatively and professionally with all co-workers, management, patients, visitors, physicians and others. Demonstrates work as a team player.
10. Performs admission of patients by completing all fields as required in an accurate and timely manner.
11. Verifies physician orders, patient information, insurance information and obtains any additional needed information at the time of admission.
12. Greets patients, families, physicians and staff in a courteous manner, and assists as needed.
13. Verifies all required information is signed and scanned at the time of admissions.
14. Cross-trains (as needed) to proficiency in Reception, Registration and Patient Accounts. Fills in as needed for breaks, illness and vacations or coverage of shifts.
15. Documents concisely, precisely and accurately in the system and on records, patient account notes or documents for every patient contact.
16. Answers incoming phone calls professionally, by identifying facility and/or department and self to caller and directing call to the appropriate destination.
17. Attends all training courses as recommended by Patient Accounts Manager.
18. Abides by all HIPAA policies and requirements.

Qualifications & Requirements

High School diploma or equivalent.

Experience Required

Minimum one-year previous experience with insurance authorization, verification, admissions and reception duties required. Demonstrated ability to work independently, prioritizing and managing multiple tasks efficiently. Demonstrated ability to solve problems and make decisions. Computer skills, basic office skills, accurate typing and knowledge of medical terminology required. Additional training or courses in business office activities preferred.