Insurance Verification Representative

Job Summary:

Responsible for verification and to ensure completion of insurance, and presence of an authorization/referral/notice of admission for various account types. Demographics are audited to assure accuracy. Updating various payer websites and payer communications is necessary. Communication with various departments, including utilization review, patient access and patient is done to expedite the process. May provide assistance to customers on financial counseling.  This is all done with the goal of a clean bill and authorized service to support the revenue cycle and payment of a bill.

Position Responsibilities:

Verification and obtaining of authorizations/precertification/notice of admission. Utilization of payer websites, faxes, and phone.

Communicating with office site staff when authorization is needed. Identifying an issue and addressing the issue with the site. Assisting departments in regard to verification/authorization.

Updating and auditing demographics including insurance information on accounts.

Assisting and directing patients for financial assistance.

Position Qualifications Required:

Required Experience:

2-3 year experience with Insurance Verification

Understanding of third party reimbursement and methodologies for all third party payers, especially pre-certification and COB regulations

Outstanding registration skills with strong insurance knowledge

Demonstrated Virtua Values

Required Education:

High School Diploma

Training / Certification / Licensure:

EPIC experience