Insurance Verification Associate

Job description

GENESIS HEALTHCARE SYSTEM In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable healthcare services, all employees of Genesis HealthCare System must be committed to living the Genesis Mission and Genesis values of Compassion, Excellence, Integrity, Team, and Innovation. All employees must regard themselves as an ‘owner’ of Genesis and keep our patients at the center of everything we do - always. Position Details: Work Shift: Varied Shift (United States of America) Scheduled Weekly Hours: 40 Department: GHS Registration Overview of Position: Responsible for verifying benefits and/or obtaining pre-certification/pre-authorization for all exams scheduled at the facility. Assists with coordinating care for all patients with prescheduled diagnostic appointments within the imaging center including pre-screening and preparation instructions prior to and after patient arrival. Handles correspondence regarding patient insurance, authorization, demographics, appointments, and financial information as applicable. Handles all correspondence, maintains files, acts as a patient liaison, receptionist, screens telephone calls within department and compiles departmental monthly reports ESSENTIAL DUTIES 1. Working knowledge of authorization criteria specific to both insurance payor and exam type. 2. Working knowledge of retro authorization and appeals process and attempting to obtain when needed. 3. Maintain an understanding of authorization standardization workflow. 4. Ensures that patients have a physician order before tests are performed or at the time of scheduling. 5. Understanding of the patient registration process including patient demographic, insurance benefits, and financial responsibility information. 6. Collect patient co-payments, deductibles, bad debt, and outstanding balances when applicable. 7. Manages multiple phone lines efficiently and with excellent customer service skills and telephone etiquette. 8. Verifies all medical benefits for scheduled exams and communicates medical insurance coverage to the patient and/or legal guardian. 9. Provide good faith estimates to self-pay patients timely to remain in compliance with the No Surprise Act. 10. Inform all true self-pay patients of presumptive eligibility opportunities and financial counseling options available. 11. Collaborate with the physician's office staff as appropriate to obtain the necessary documentation, including pre-authorizations for all diagnostic exams. 12. Pre-register all patients in an accurate and efficient manner. 13. Demonstrates understanding of medical diagnosis with correct spelling. 14. Demonstrates complete understanding and ability to apply patient access policies and procedures. 15. Demonstrates knowledge to scan appropriate documents and search for documents in EPIC. 16. Demonstrates knowledge of insurance and authorization web portals. 17. Demonstrates ability to analyze and evaluate any presented problems by utilizing critical thinking. 18. Knowledge of electronic prior authorization process specific to Rhyme. 19. Consistently coordinates work to achieve maximum productivity and efficiency during the assigned shift. 20. Demonstrates a willingness to stay late, and work weekends or other shifts to accommodate department needs. QUALIFICATIONS 1. High school graduate or equivalent. 2. Knowledge of insurance verification, with two years experience verifying and obtaining medical pre-certification. 3. Solid written and verbal communication skills. 4. Strong computer experience, including MS Word and Excel, and experience using other office equipment. Will be required to learn department-specific programs. 5. Demonstrated ability to prioritize and handle multiple tasks simultaneously. 6. Ability to work with minimal supervision and effectively solve problems. 7. Working knowledge of medical terminology. PATIENT CENTERED CARE & BEHAVIORAL EXPECTATIONS 1. Living the Genesis Mission, Vision and Values • Performs work in a manner that is quality focused. • Treats patients, co-workers, visitors and volunteers with courtesy, compassion, empathy and respect. • Results oriented and focused on achievement of objectives. • Acknowledges and responds to the diversity of people and the situation. • Encourages peers (others) to be owners of change. • Always makes the effort to anticipate and exceed customer needs and expectations. • Possesses the ability to engage others with patience and understanding. • Acts in a manner that creates positive first and lasting impressions. • Demonstrates the ability to own issues until they are resolved. 2. Patient Centered Care (patients/families, physicians, co-workers, all other internal/external customers) • Introduces self and role…connects with everyone. • Communicates effectively (i.e. advising others of actions, pertinent information, time durations, etc.) and asks for feedback. • Asks for and anticipates needs and concerns of others. • Maintains a positive work environment for staff and a healing environment for patients (i.e. safe, clean, quiet, etc.) • Maintains the dignity and privacy of each person; manages confidential/sensitive information appropriately. • Responds to requests in an appropriate and timely manner. • Exits patient/customer encounters courteously, asking if there are additional needs that can be addressed. 3. Promotes Patient and Employee Safety • Demonstrates safe patient handling (i.e. transfers, transport, care administration, nutrition, medication, etc.). • Demonstrates safe materials handling (i.e. appropriate use and disposal of chemicals, infectious wastes, etc.). • Demonstrates appropriate knowledge of Infectious Disease precautions and use of proper protective equipment. • Demonstrates Slips/Trips and Falls Awareness. • Actively contributes to maintaining a safe, clean and quiet environment. WORKING CONDITIONS/PHYSICAL REQUIREMENTS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Works in a noisy environment with continual interruptions. 2. Must work at a computer terminal for 6-8 hours a day. 3. Must apply clinical knowledge and have the ability to read, write and utilize a computer. 4. May be required to periodically rotate shifts and regular days off. All system employees must be willing to work all shifts, extra hours, holidays and emergency shifts as required. 5. May be required to work at different registration locations (FCN, FCS, HealthPlex etc.) 6. Must be able to lift 10 pounds, and frequently lift and/or move 25 pounds. 7. Employee has to be able to push and pull COW”S (Computer on Wheels). This description reflects in general terms the type and level of work performed. It is not intended to be all-inclusive, nor portray the specific duties of any one incumbent. Thank you for your interest in employment at Genesis. Genesis is committed to being an equal opportunity employer. Selection of applicants for employment is based only on qualifications and the requirements of a specific job.