Surgical Care Affiliates

  • Insurance Verification Representative

    Job Location US-CA-Laguna Woods
    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:

    The MemorialCare Surgical Center Laguna Woods is a multi-specialty Ambulatory Surgery Centers located in  in South Orange County.  The center specializes in multiple service lines with accreditation status from AAAHC and CMS. The Surgery Center is in the vicinity of Southern California’s best beaches, attractions, dining and shopping.  Great location for the outdoor enthusiasts as well. 

    Accountabilities / Responsibilities

    The Insurance Verification Representative is responsible for providing each patient with their insurance information regarding overall cost of their procedure.  This includes working with various insurance companies to verify eligibility, benefits and amount patient will owe for any deductibles, copays or coinsurance. The Insurance Verification Specialist

     

    Key Responsibilities:

    • Verify enough patient and insurance information is available for accurate verification and eligibility.
    • Utilize the payer websites to obtain eligibility, benefits and/or pre-certs and authorization information.
    • Calculate co-pay and co-insurance due from patients per the individual payer contract.
    • Enter accurate patient insurance information and financial class into patient accounting system.
    • Follow the Policies and Procedures when accepting Out of Network payers.
    • Document all information and communications in the patient account.
    • Contact patients with estimated co-insurance, co-pay and deductible amounts due the day of service and the center financial policy 1-2 weeks prior to the day of service.
    • Enter accurate patient insurance information and financial class into patient accounting system.
    • Obtain authorizations from insurance companies/physician offices.
    • Ensure the procedure scheduled, date of service and facility name are on the authorization and accurate.
    • Check insurance company approved procedure lists/medical policies to ensure procedure is payable.
    • Be familiar with individual payer guidelines and the process of collecting over the counter.
    • Knowledge of payer contracts.

    Qualifications

    • Associates Degree or equivalent from two-year college or technical school; or six months to one-year experience in a medical office, hospital, outpatient surgery center or related field.
    • Computer experience, Excel, Word, Medical Applications
    • Self-Starter
    • Good Phone etiquette
    • Customer Service oriented

    Options

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