Franklin, TN, 37065, USA
1 day ago
Insurance Verify Rep
The Insurance Verification Specialist, under the direction of the PAU Manager or Supervisor, verifies benefit coverage, medical necessity, authorization, and referral requirements. This position supports our Shared Services Center and client hospitals around the country for a wide variety of payors and patient types by providing top-notch support to the entire revenue cycle. **Essential Duties and Responsibilities:** + Verifies detailed insurance benefits, medical necessity, and authorization/referral guidelines, consistently prioritizing and following the established verification processes. + Communicates outstanding documentation requests, required account follow-up, and payor issues to the appropriate facility contacts. + Responsible for maintaining performance standards that ensure the department is operating at peak proficiency and that established goals are consistently being met while maintaining effective communication with patients, physicians, medical office staff, and both internal and external co-workers. + Calculates the estimated patient financial responsibility via the estimation tool. + Notates all actions performed in the applicable host system(s) immediately. + Performs all other duties, as assigned or requested, while adhering to strict deadlines. **Qualifications:** + Required Education: High School Diploma or Equivalent + Required Experience: 1+ years of medical office, medical insurance company, or healthcare facility experience + Knowledge of CPT, ICD-10, and medical terminology + Required License/Registration/Certification: None + Preferred License/Registration/Certification: Certified Professional Coder (CPC) Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.
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