Surgical Care Affiliates

  • Insurance Verification Representative

    Job Location US-NC-Raleigh
    Type
    Full-Time
    # of Openings
    1
  • Overview

    SCA, a leader in the outpatient surgery industry, strategically partners with health plans, medical groups and health systems across the country to develop and optimize surgical facilities. SCA operates more than 210 surgical facilities, including ambulatory surgery centers and surgical hospitals, in partnership with approximately 7,500 physicians. For more information on SCA, visit www.scasurgery.com.

     

    Facility Description:

     

    Blue Ridge Surgery Center is a fast pace multi-specialty ambulatory surgical center with 6 OR’s, and 2 procedure rooms. We average 700 cases a month. We are a values base company which places clinical first.

    Accountabilities / Responsibilities

    The Insurance Verification teammate is responsible for ensuring scheduled procedures are on the patient’s

    insurance covered list and/or the patient meets self-pay criteria. The Insurance Verification teammate will be

    responsible for verifying insurance coverage, eligibility, benefits, obtaining authorizations and pre-certs as

    required by the individual insurance company.  The teammate will verify that all scheduled procedures are on

    the ASC procedure listing.  The Insurance Verifier will be familiar with and understand Medicare, Medicaid,

    other government payers, Commercial and HMO/PPO Payers guidelines and principals.

                                                                   

    The Insurance Verification teammate will be responsible for calculating co-insurance estimates per the payer

    contract as applicable and amounts due from self-pay patients are according to the center self-pay guidelines,

    Policies and Procedures.  The teammate will enter the verification, eligibility and benefit information in the

    patient accounting system to include the date, time and method used to obtain the verification/eligibility

    information for each patient.  The documentation will include the amount expected from the patient on or

    before the date of service.

                                                                   

    The Insurance Verification Clerk is responsible for communicating insurance benefit information and financial responsibility to each patient during a Pre-Registration Financial Orientation call prior to the date of service.  The verifier is responsible for verifying the patient demographic and insurance information along with subscriber information and secondary insurance as applicable during the Pre-Registration Financial Orientation call.

     

    Key Responsibilities:

    • Responsible for verifying insurance coverage, eligibility, benefits, obtaining authorizations and pre-certs.
    • Accountable for calculating accurate estimates of benefits and amounts due by the patient on their date of service.
    • Conduct financial orientation phone calls with patients prior to their procedures.

    Qualifications

    • Associates Degree or equivalent from two-year college or technical school AND one-year experience in a medical office, hospital or outpatient surgery center.
    • Experience with health insurance and medical terminology
    • Familiar with individual payer guidelines and the process of collecting over the counter payments/deductibles/co-pay/co-insurance
    • Computer experience: Excel, Word, Medical Applications
    • Self-Starter with good phone etiquette

     Preferred

    • Insurance Verification Experience

    Please send resumes to kathryn.lennert@scasurgery.com

    2018-4852

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed