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United Surgical Partners International, Inc · 2 days ago

GI Tech - FT

Greenville, NC

Full-time

Onsite

Mid Level

United Surgical Partners International, Inc is a healthcare provider seeking an Insurance Specialist. The role involves securing financial accounts, verifying insurance coverage, and ensuring timely reimbursement while providing excellent customer service to patients.

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Responsibilities

Notify Case Management daily of all inpatient and observation patient admissions to ensure communication to insurance companies of patient’s status

Accurately obtain via fax, telephone or personal interview, the required financial and insurance information from the patient, patient’s representative, scheduling or physician’s office

Verify and obtain insurance coverage and benefits via insurance company website, insurance eligibility programs or by telephone for all patients registered for services for all payer types. Consistently strives to stay a minimum of three (3) business days in advance of patients arrival

Perform notifications and obtain pre-authorizations and/or per-certifications for timely and accurate reimbursement. Determine appropriate financial class and accurately enter the data into the system

Communicate insurance coverage details to patients and inform the patient/guarantor prior to service date regarding payment expectations related to co-payments, co-insurance, and/or deductible amounts. Establish payment arrangements as appropriate according to established guidelines

Notify patients of any required and expected co-pay’s, deductibles or co-insurance payments prior to their arrival

Attempt to collect patient payments during initial phone contact in order to alleviate the amount of effort and time required on the day of service

Log cash collections, generate receipts and maintain a balanced cash drawer at all times. Post payments to patient’s account as required

Document in the patients account notes any information that will assist the business office in their efforts to understand the issues that may impact efficient billing, questions about the status of the claim or other follow-up

Provide assistance to patients when they present to the facility in person with questions regarding billing or open accounts

Inform Department Director or Team Lead of potential problem accounts or additional requirements for reimbursement to receive direction on how to resolve situations

Consistently demonstrate premier customer service and communication skills with all internal and external customers/contacts and ensure the patient and their family members have the best hospital encounter possible

Consistently respond to all incoming calls within the third ring

Meet established quality and productivity standards for self and for the team

Anticipate and adapt to change (e.g., hospital policy changes, operational/procedures, insurance changes) in a positive manner

Foster and reinforce team-based results

Adhere to time and attendance standards as outlined in the Human Resource Policy manual. Provide proper notification of absence or tardiness within established departmental time frames

Ensure patient confidentiality adhering to HIPAA guidelines

Demonstrate the knowledge, skills and abilities (competencies) to perform the duties outlined above annually in the form of a test or as evidenced by daily quality review and direct observation of the Team Lead and/or the Department Director

Track and monitor productivity as requested

Keep Department Director apprised of any delays in the registration process

Remain current on scheduling, registration, insurance verification, and other patient registration processes in order to cover in the absence of other team members

Perform other duties as assigned

Qualification

Patient registration experienceInsurance verification knowledgeAuthorization processesManaged care knowledgeGovernment regulations knowledgeTyping 40 WPMBasic computer skillsCommunication skillsInterpersonal skills

Required

High School graduate or equivalent required; 2 years college preferred

Experience in patient registration, verification and authorization in a medical center or comparable required

Working knowledge of managed care, Medicare, worker's compensation, indemnity and other third party payers required

Working knowledge of governmental regulations and other reimbursement criteria required

Ability to accurately type 40 WPM, complete forms, simple correspondence and enter data

Excellent verbal and written communication as well as interpersonal skills required

Demonstrated ability to handle multiple tasks with short time-lines, prioritize and organize work, and complete assignments in a timely and accurate manner

Exceptional ability to interact and communicate effectively, tactfully, and diplomatically with patients, families, medical staff, co-workers, employers and insurance company representatives

Must have a pleasant disposition, positive attitude and possess the ability to maintain a cordial and professional approach during periods of stress

Skill in using office equipment: basic computer skills, photocopier, telephone, fax machine, and calculator

Demonstrated ability to think and act decisively in a timely manner

Ability to maintain operational knowledge of all insurance requirements necessary to achieve optimal reimbursement

Company

United Surgical Partners International, Inc

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United Surgical Partners International (USPI) is the largest ambulatory surgery platform in the country and operates ambulatory surgery centers and surgical hospitals.

Founded in 1998