Visit Eligibility Validation Coordinator, Nucleus Building, 8:00a-4:30p

Primary Location:

Address:

Shift:

Job Description Summary:

Job Description:

Medical insurance verification of patient accounts to determine eligibility, benefits and co-pays due and ability to analyze patient accounts for outstanding balances as well. Pre work GECB hold bill alerts and update visit insurance. Must be detail oriented and possess strong communication and interpersonal skills with the ability to multi-task.

Essential Functions:

• Verifies patient eligibility six days out from appointment
• Determines patient’s benefits including deductibles, co-insurance and co-pay amounts
• Verifies if authorizations are required and obtain, if necessary
• Verifies benefits
• Calls patients prior to appointment if there is a problem with patient’s insurance
• Works with patients to pay balances on account or create payment plan for balances due
• Works hold bill and marked event alerts
• Determines what is needed for the upcoming visit ex; consent, arrival form, ID, insurance card, picture, etc.
• Works visit insurance and arrange FSC accordingly

Other Functions:

• Maintains compliance with all company policies, procedures and standards of conduct
• Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
• Performs other duties as assigned

Additional Job Description:

Education:

• High school diploma or GED/Equivalent (required)

Experience:

• Five (5) years of insurance experience (preferred)

Licensure:

• N/A

Certification:

• N/A

Job Competency:

Knowledge, Skills, and Abilities critical to this role:

• Understanding of insurance policies and processes
• Ability to utilize insurance websites proficiently
• Ability to anticipate and adapt to change positively
• Must possess solid customer service skills
• Strong interpersonal and communication skills- responsive, informs constituents of process, pleasant to work with, educates and provides timely, accurate information; can build effective, strong working relationships others through trust, communication, and credibility
• Demonstrated organizational skills – manages time effectively, keeps tasks appropriately prioritized with the ability to change directions as needed for the good of the department or organization;
• Strong work ethic– motivated, diligent, industrious and persistent in the workplace, stays on tasks to completion, works at a fast pace to ensure optimal efficiency; is able to perform work in a neat, efficient, well-coordinated, well communicated manner with a high degree of accuracy and professionalism
• Proven ability to work on a team – ability to work with others, serve others, help others, lead others, mentor others, take directions from others in the interest of moving process and programs forward to the desired outcome; able to see the big picture in emotionally charged situations and respond in a mature, professional, composed manner
• Maintains a professional appearance at all times

Language Ability:

• Must be able to communicate effectively in both verbal and written formats

Reasoning Ability:

• Strong investigative and problem solving skills
• Ability to break down problems or tasks; scanning one’s own knowledge and experience to identify causes and consequences of events

Computer Skills:

• Proficient in Microsoft Office
• Extensive knowledge of Centricity

Additional Responsibilities:

• Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times
• Maintains confidentiality and protects sensitive data at all times
• Adheres to organizational and department specific safety standards and guidelines
• Works collaboratively and supports efforts of team members
• Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community