Insurance Verification Assistant
Company: Sigma Inc
Posted on: November 24, 2022
23-128-778 - Insurance Verification Assistant, Plymouth, MA,3
Sigma Inc is looking for a Insurance Verification Assistant -who
would be working with our team Central Scheduling Department at
Shift: 9:00 AM to 5:30 PM
- Verifies insurance eligibility utilizing available
technologies, payer websites, or by phone contact with third party
- Ensures that correct insurance company name, address, plan,
policy number and filing order are recorded in Soarian
- Works payer exceptions work queues utilizing the HDX batch
process. Alerts infusion areas of any pre-service insurance changes
by adding encounters to the SharePoint list.
- Contacts primary care physicians to obtain referrals for
patients coming to the organization for specialty visits. Contacts
patients when the primary care physician is not known in order to
- Enters insurance referrals into the IDX computer
- Provides telephone assistance to all specialty clinics and
insurance companies in locating missing referrals.
- Investigates all elective same day surgeries and inpatient
admissions for referral and or authorization requirements. Ensure
that accurate and complete referrals/authorizations are in place
utilizing the CPT codes and ICD 10 codes provided.
- Completes notification for all urgent/emergent
surgeries/admissions following payer guidelines via phone, fax,
E-mail or payer website.
- Monitors inpatient level of care throughout inpatient stay to
ensure that all notification and authorization requirements are
- Ensures that payer authorizations are approved and accurate
after patient is discharged and final admission status is
- Utilizes the SharePoint Surgical Scheduling site to communicate
with the surgical areas regarding authorization/referral
- Inputs all insurance company requests for clinical
documentation into Curaspan for Case Management.
- Verifies insurance coverage using automated eligibility systems
and payer websites.
- Obtains auto liability information on auto accident cases
including copies of the police report, contacting insurance company
and or patient or next of kin.
- Corresponds with third party carriers and/or patients to obtain
insurance data and authorizations.
- High School diploma or equivalent.
- 3+ years of business office or related insurance
- Knowledge of third party requirements as they relate to
insurance verification / authorization.
- Demonstrated ability to work with computerized systems such as
a PC, Point of Service device and online interfaced
- Must possess communication skills sufficient to interact with
multiple departments and organizational ability to manage
Keywords: Sigma Inc, Plymouth , Insurance Verification Assistant, Other , Plymouth, Massachusetts
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