Insurance Verification Rep
Insurance Verification Rep
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Job Description
Overview
CHI Health strives to care for you the way you care for your patients.
We understand you have personal responsibilities outside of your profession and also care about your well-being.
With you in mind we offer the following benefits to support your work/life balance:
- Health/Dental/Vision Insurance
- Direct Primary Plan (No copay no deductible and access to CHI Health provider 24/7)
- Premium Access to our Family Care Program supporting your needs for childcare pet care and/or adult dependent care
- Voluntary Protection: Group Accident Critical Illness and Identity Theft
- Employee Assistance Program (EAP) for you and your family
- Paid Time Off (PTO)
- Tuition Assistance for career growth and development
- Matching 401(k) and 457(b) Retirement Programs
- Adoption Assistance
- Wellness Programs
- Flexible spending accounts
From primary to specialty care as well as walk-in and virtual services CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours.
Responsibilities
This job is responsible for completing insurance verification of benefits obtaining behavioral authorizations completing pre-registration and registration as needed answering questions via phone and email from front desk staff and patients. An incumbent conducts verification authorization through phone calls online processing fax and written correspondence leveraging work queues to organize work efficiently.
Essential Function
- Applies a thorough understanding/interpretation of Verification of Benefits (VOB) to confirm patient eligibility
- Communicates effectively over the phone and through written correspondence with providers clinical staff clinic managers and payers to obtain VOB and behavioral authorizations.
- Applies understanding and knowledge of medical terminology payer guidelines CPT codes ICD-10 codes to ensure appropriate behavioral authorizations are obtained
- Recognizes when additional assistance is needed to resolve complex issues and escalates appropriately and timely through defined communication and escalation channels.
- Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies procedures and other job aides.
- Works the claim edit work queues timely and efficiently to correctly resolve the error.
- Assists with unusual complex or escalated issues as necessary.
- Accurately documents behavioral authorizations VOB and co-pay amounts.
Qualifications
Education and Experience
Education Level
Education Details
Grace Period
And/Or
Experience
Experience Details
Required/Preferred
And/Or
NONE
Licensure and Certifications
Licenses/Certifications
Compact Accepted
Grace Period
Required/
Preferred
And/Or
None (None)
N/A
upon hire
Employment Type
Unclear
