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CORE JOB SUMMARY
The Sr. Insurance Verification Representative verifies insurance eligibility and authorization for all contracted and non-contracted insurance carriers and takes appropriate steps to facilitate reimbursement to department for services rendered.
CORE JOB FUNCTIONS
1. Verifies insurance information with patients for scheduled appointments and contacts payer to verify eligibility and authorization requirements.
2. Adds or updates financial status classifications in appropriate systems.
3. Contacts caregivers and patients for HMO payers to obtain authorizations and referrals.
4. Generates and links referrals to appropriate visit once authorization is obtained.
5. Responds to customer inquiries regarding insurance coverage of services and processing of claims.
6. Follows appropriate procedures to link alternative insurance plan payers to the appropriate programs during registration.
7. Identifies non-contracted HMO payers and refers to proper managing department.
8. Serves as a lead Insurance Verification Representative and assists in training new staff.
9. Adheres to University and unit-level policies and procedures and safeguards University assets.
This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.
CORE QUALIFICATIONS
Education:
High School diploma or equivalent required
Experience:
Minimum 3 years of relevant experience required
Certification and Licensing:
Refer to department description for applicable certification requirements
Knowledge Skills and Abilities:
This is a core job profile description and is not reflective of all duties that may be assigned to a specific position in each individual department. The above statements are intended to describe the general nature and primary responsibilities of this core job profile. Specific duties and tasks may vary based upon departmental needs. Other duties may be assigned to the above consistent with the knowledge skills and abilities required for the job.
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Job Status:
Full timeEmployee Type:
StaffPay Grade:
H4Required Experience:
Senior IC
Full-Time