Insurance Verifier-8110

Staff Position Description Position Title: Insurance Verifier Position Code: Verifier-8110 Department: Patient Access Safety Sensitive: YES Reports to: Admitting Supervisor/Manager Exempt Status: NO Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision of providing the region's best clinical care and patient service through an environment that fosters respect for others and pride in performance.

Key Responsibilities

[List of material responsibilities and essentials duties which must be completed in achieving the objectives of the position]

• Provides excellent customer service and adheres to the Behavioral Expectations Agreement.
• Verifies insurance coverage and obtains necessary authorization on observation and inpatient accounts within 24 hours or the next working day (to include completing DES applications for self-pay patients.) Obtains extensions as appropriate.
• Conducts financial counseling and collect patient liability amounts.
• Protects the patients and the hospital financial reimbursement by inputting authorization information, verifies the insurance and ensures that all notification/ authorizations are completed according to financial class department policy.
• Conducts duties in order to protect the financial integrity of the hospital.
• Provides guidance and instructions in the interpretation of admitting policies, procedures and practices.
• Inputs notes pertinent to financial information to assist billing department in payment of the claim and drops insurance flags on accounts.
• Contacts responsible party of inpatient accounts either in person or by telephone to advise of insurance coverage rate when insurance does not cover 100%.
• Professionally advises responsible party of payment requirements and follows hospital policy in establishing payment arrangements.
• Completes self-pay assistance applications when appropriate. Preferably prior to discharge.
• Audits all inpatient files to ensure that insurance cards, orders and other admission documents are complete and copied as needed for scanning.
• Ensure admissions documents are scanned and perform Quality Assurance audits on your scanned documents prior to destroying.
• Maintains statistical information and completes month end stats timely (by the 4th day of the following month) and accurately.
• Maintain admission reports daily (billing error report – admissions/discharge summary).
• Consistently demonstrates a willingness to assist co-workers in a courteous manner to support department efficiency.
• Ability to flex into admitting representative tasks at any given notice.
• Performs and communicates in a highly professional manner at all times.
• Consistently demonstrates the ability to assess a situation from a variety of perspectives.
• Considers alternatives and chooses the most appropriate course of action.
• Other duties as assigned.
• Monitors communication with patients regarding their admission, ensures positive outcome, safeguards the public image of the hospital.
• Demonstrates enthusiasm and self-motivation in performing job duties.

Qualifications

[Statements regarding minimum educational and experience qualifications, required proficiencies with specialized knowledge, computer proficiencies, military service, required certifications, etc.]

• Excellent customer service skills, and the ability to communicate effectively with others.
• Manage multiple priorities and tasks.
• Maintain attention to detail.
• Ability to organize and sort the daily workload while utilizing effective interpersonal skills through both telephone and face to face contact.
• Knowledge of and have the ability to use computer hardware and software applications.
• Knowledge of medical insurance, managed care and basic business office functions.

Education

High school diploma or equivalent Experience: Minimum of two (2) years in hospital or medical office business setting Preferences [Preferred attributes for the position which are not absolutely required in the minimum qualifications (i.e., multi-lingual, master's degree)] Education: Some college education preferred. Experience:

• Financial counseling experience.
• Insurance billing and medical terminology. Special Position Requirements [Optional section: any travel, security, risk, hazard or related special conditions which apply to the position] Exposure Categories: Category II: Expected duties have possible, but not routine, potential for exposure to blood, body fluids or tissues Work Requirements [Optional section: work requirements for physical or other important issues which relate to the job]
• Position requires sedentary work, occasionally carrying small objects short distances.
• Must be able to sit at a terminal for up to seven (7) hours daily.
• Must be able to bend, stoop and reach for files and supplies.
• Must be able to get up from chair regularly to get paperwork. Date Staff Position Description Created / Revised: 03/01/2019