Providence is calling an Insurance Verifier (Per Diem/Day shift) to the Patient Financial Services department at Providence Little Company Medical Center in Torrance, CA.
In this position you will:
- Under the supervision of Supervisor, Patient Financial Services Operations the insurance verifier is responsible for ensuring that all outlined client scheduled accounts are verified and accounts are completed accordingly and may include any non-scheduled procedures such as add-ons, direct admits and transfers.
- The insurance verifier is responsible for making the telephonic process as pleasant as possible for all patients and their families additionally responsible for communicating payment policies and providing patient education as it relates to insurance benefits.
- This position ensures coordination and communication between departments becoming a resource for the patient, physician, and facility.
- The insurance verifier must accurately collect and input patient information into the database to ensure accurate billing and complete medical record attainment.
- The insurance verifier functions includes preregistration, insurance selection, interpretation of insurance contracts, collaborating with Manage Care contracting on obtaining Letter of Agreements, gathering patient complex demographics, benefits collections, and authorizations for the CA region.
- This position is responsible for the day to day operations of the department that verifies various types of insurance benefits from simple office visits to very complex surgical and medical procedures, securing authorization, notification for Inpatient and Outpatient surgery and Inpatient admissions for account information for reimbursement.
- This position is also responsible for ensuring patient satisfaction as it relates to securing accounts prior to the patients arrival to the medical centers.
- Resolve complaints, using patient satisfaction data to improve processes and partnering with clinical departments served to ensure incoming referrals to Providence are maximized.
- Must maintain up-to-date knowledge and competency with numerous federal, state and other regulatory body compliance regulations and third party insurance plans.
- Complexity of this position is evidenced by the use of simple and complex medical terminology and insurance verification protocols.
- The insurance verifier displays professional interpersonal skills and presence when communicating with physicians, staff and the public; as the front-line customer service representative, upholds and exhibits the core values in all communication.
- It is essential that this information be documented timely and accurately.
Required qualifications for this position include:
- A minimum of one (1) years' experience in customer service in healthcare (clinic or hospital) registration.
- Experience working with insurance verification and authorizations.
- Demonstrated knowledge of CPT and ICD10 coding and medical terminology.
- Knowledge and experience with State, Federal and other regulatory Compliance Regulations including: Medicare Secondary Payer, EMTALA ad ABN.
Preferred qualifications for this position include:
- High School Diploma or GED equivalent.
- Able to interpret Insurance benefits for outpatient and inpatient surgery strongly preferred.
- Inpatient notification.
- Knowledge of insurance billing and managed care preferred.
- Some college level course work preferred particularly Medical Terminology or Medical Assistance coursework.
- Satisfactory completion of college level Medical Terminology or Medical Assistant course.
- Previous registrar, pre-registration, insurance verification and third party payer experience.
- Healthcare experience in a hospital or clinical setting, health insurance or medical office.
- Certified Healthcare Access Associate (CHAA) or Certified Revenue Cycle Specialist (CRCS).
About the Region you will serve.
For nearly 70 years, Providence Health & Services, Southern California, has provided quality and compassionate health care, building on a tradition of excellence, innovation, teamwork and outreach to those most in need.
Anchored by five award-winning comprehensive medical centers, Providence provides a full spectrum of care that includes a range of specialties, signature services, outpatient and home care and the well-regarded Providence Medical Institute, a group of physicians and primary and urgent care clinics throughout the greater San Fernando Valley and South Bay. Providence is focused on providing the communities it serves with preventive care, education and leading-edge diagnostics and treatment. The organization includes numerous outreach programs. hospice and home care and even our own Providence High School, a Blue Ribbon college-preparatory campus.
We offer a full comprehensive range of benefits - see our website for details
As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.
Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 82,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 600 physician clinics, senior services, supportive housing and other health and educational services. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Schedule: On Call
Job Category: Finance & Accounting
Req ID: 151964