Insurance Verifier Full Time Day
Full Time, Days
Florida Hospital Fish Memorial
For a young hospital built in 1994, Florida Hospital Fish Memorial has a long history dating back to 1952. Beginning as a humble, 50 bed facility more than six decades ago, we’ve grown to become one of Volusia County’s most comprehensive and trusted healthcare resources. With Florida Hospital's tremendous resources and expertise, our community hospital has continued to thrive due to constantly improving advanced medical technologies and experienced clinical talent.
Through our dedication to excellence we have been recognized as Orlando Sentinel’s "Top 100 Companies for Working Families" for 9 consecutive years. We also received the Performance Achievement Award from the Medicare Quality Improvement Organization of Florida, as well as, the 24th Annual Commissioner’s Business Recognition Award from the Florida Educational Foundation and Florida Department of Education.
As a member of Adventist Health System, Florida Hospital Fish Memorial operates as a not-for-profit organization focused on improving the health of the community it serves. This is a direct reflection of our mission to extend the healing ministry of Christ with skill and compassion." Best of all, it’s just a short trip from some of Florida’s most exciting attractions—and minutes from the beaches in Daytona!Qualifications
- Gathers required information from the scheduling module to ensure all scheduled patients are authorized prior to date of service.
- Reviews the Denial/Rejection list from Denials Management and determines cause for denials, provides Patient Accounting with documentation if the denial is inappropriate, educates the staff concerning errors that caused the denial, communicates with Managed Care department regarding discrepancies in information obtained from contracted insurance carriers.
- Ensures accurate demographics and proper identification of each patient by verifying social security number, date of birth and spelling of name.
- Determines proper financial class and insurance codes by requesting insurance information and assigning current code as specified in pneumonic index.
- Makes initial attempt for all scheduled visits to obtain precert/authorization/referral prior to date of service by calling appropriate insurance or by verifying electronically whenever appropriate.
- Completes authorization and referral process within established time frames according to Patient Financial Services goals as observed by Manager.
- Maintains accuracy of registration by entering correct clinical information regarding physician, complaint and diagnosis.
- Protects the legal and financial standing of Florida Hospital East Region by obtaining appropriate authorization forms, and other forms as required for the insurance plan.
- Adheres to the Florida Hospital Corporate Compliance plan, and to all the rules and regulations of all applicable local, state, and federal agencies and according bodies.
- Reviews missing authorizations the day before scheduled visit, and obtain necessary authorization/referral or notify scheduling to reschedule patient.
- Assists in registration and/or scheduling when necessary to maintain the department’s efficiency.
- Contributes to the attainment of Patient Financial Services Days in Receivable goals by communicating to the registrar all benefits and patient responsibility so that accurate collections are made at time of service.
- Responsible for insurance verification process for Scheduling Outpatients, Inpatients and Same Day Surgery patients as assigned.
- Must have typing skills of at least 40 wpm.
- Proficiency in the performance of basic math functions, capability to communicate professionally with an acceptable use of English and spelling.
- Most work is repetitive, and new situations arise frequently, which require good judgment in the application of available policies and procedures.
- Must use good judgment and take initiative to resolve immediate or urgent problems.
- Must be proactive in developing processes to improve efficiency and services of the Verification area.
- Must be able to act quickly when emergency situations occur, such as fire, security or disaster.
- Must be able to coordinate multiple projects at the same time and maintain professional demeanor.
- Must be a quick learner and have excellent memory in order to process accounts in a timely manner.
- A high school education or equivalent is required.
- An Associates Degree is preferred.
- College courses or the equivalent in computer programs (Outlook,Excel, Word, Power Point) is encouraged.
- One year of registration or scheduling experience in a Health Care setting is preferred.