Compensation range:

Your rate of pay will be based on applicable experience

Enloe Health is a Level II Trauma Center located in beautiful Northern California. We offer a full array of medical services and our mission is to elevate the health of the communities we serve. As a Planetree organization we place high value on hiring the right team to care for our patients and their familiescare that is steeped in compassion human connection and mutual support. If you feel called to make a meaningful impact through empathetic person-centered care and thrive in a culture that values collaboration and purpose we welcome you to join our team.

POSITION SUMMARY:

The Insurance Verification Rep is responsible for demonstrating and maintaining a higher level of knowledge and expertise in relation to all areas of insurance plans and selection. Insurance Verification Representative is to be an expert in verification of validity of effective insurance coverage the necessity of authorization and obtaining of benefit details on appropriate/assigned account types for incoming and in-house patients. Insurance Verification Representative is responsible for timely reporting to insurance carriers of appropriate admissions and ensuring authorization is obtained by referring physician on all inpatient and outpatient accounts requiring referrals authorizations or other pertinent documentation; ultimately ensuring reimbursement for services rendered at Enloe Medical Center for inpatient observation surgical and high dollar accounts. The Insurance Verification Representative is responsible for maintaining high level of knowledge of Patient Access activities and is to be a resource to their team and to members of the Medical Center and provider office staff to facilitate efficient operations expeditious reimbursement and optimal consumer satisfaction and to promote teamwork. Is also responsible for identifying and correcting insurance selection errors to ensure accounts are clean billable accounts. The Insurance Verification Representative must be willing to work on Holidays as scheduled when insurance companies are open so as to meet requirements in timely reporting of admissions. Insurance Verification Representative must work efficiently and in keeping with established procedures to ensure accounts are appropriately referred to the Financial Counselor in a timely manner so as to ensure the patient is aware of their financial responsibility well in advance of scheduled services. The Insurance Verification Representative is responsible to consistently demonstrate the core values of Enloe Medical Center. The Insurance Verification Representative is responsible to perform their duties in accordance with regulatory compliance requirements and the Medical Centers Code of Conduct.

EDUCATION / TRAINING / EXPERIENCE:

Minimum:

• Competency as a Patient Access Representative II at Enloe Medical Center OR one year hospital or physician office Insurance Verification experience

Desired:

• Knowledge of ICD 9/10 Coding and CPT Codes
• Previous Insurance Verification experience in a hospital setting
• Basic Medical Terminology

SKILLS / KNOWLEDGE / ABILITIES:

This position interfaces with all levels of personnel within the hospital and provider office setting as well as multiple insurance companies. Must demonstrate the ability to communicate professionally with excellent customer service skills. Must be proficient in Microsoft Office (Word/Excel/Outlook). Must demonstrate positive professional and effective interpersonal relations with insurance companies and representatives physicians and their staff and medical center staff including Pre-Registration Case Management Financial Counselor and Patient Access supervisor(s) and Manager as well as the PFS Manager and Director. Must demonstrate the ability to work in a multidisciplinary team environment. On occasion must demonstrate the ability to communicate with patients and families during time of emotional and physical stress. Must demonstrate sensitivity and compassion for the hospitalized patient and family. Must maintain all protected patient information in strict confidence. Must demonstrate high ethical standards and comply with applicable State and Federal regulatory requirements. The Insurance Verification Representative must have the ability to obtain and provide ICD 9/10 Codes and CPT Codes with accuracy to insurance providers when requested. Ability to recognize HMO plans verses PPO EPO etc. Ability to identify research and correct account and insurance selection errors of patient access staff refers appropriately to root cause process so account error can be shared with representative who created the error for educational purposes and to facilitate in improved accuracy resulting clean billable accounts. Must demonstrate competency in performance of their job duties in accordance with department standards. Must demonstrate the ability to work independently as well as follow instructions work quickly and accurately in a fast paced environment. Must demonstrate the ability to organize and prioritize assignments. Must demonstrate reliability and dependability by reporting to work as scheduled. Must demonstrate the ability to work under conditions of frequent interruptions and willingness to be flexible and adapt to change. Must be able to fulfill the essential functions of the position.

Benefits Information

Enloe offers a comprehensive and competitive benefits package to all eligible employees including but not limited to:

• $0 premium medical plan to include vision insurance
• Prescription and dental group insurance
• Retirement with employer match
• Generous paid time off (PTO) plan that starts accruing immediately and can be used as its earned
• Extended Sick Leave
• Flexible Spending Accounts for unreimbursed medical expenses and dependent care
• Employee Assistance Program
• Educational Assistance

Please visit the employee benefits page at get more in-depth benefits and coverage information or email to receive a full summary of benefits.