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Insurance Verification Assistant

Company: Sigma Inc
Location: Plymouth
Posted on: November 24, 2022

Job Description:

23-128-778 - Insurance Verification Assistant, Plymouth, MA,3 months

Sigma Inc is looking for a Insurance Verification Assistant -who would be working with our team Central Scheduling Department at Plymouth MA.

Shift: 9:00 AM to 5:30 PM

Responsibilities


  • Verifies insurance eligibility utilizing available technologies, payer websites, or by phone contact with third party payers
  • Ensures that correct insurance company name, address, plan, policy number and filing order are recorded in Soarian Financials.
  • 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 obtain referrals.
  • Enters insurance referrals into the IDX computer system.
  • 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 completed.
  • Ensures that payer authorizations are approved and accurate after patient is discharged and final admission status is known.
  • Utilizes the SharePoint Surgical Scheduling site to communicate with the surgical areas regarding authorization/referral status.
  • 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.

    Requirements


    • High School diploma or equivalent.
    • 3+ years of business office or related insurance experience.
    • 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 systems.
    • Must possess communication skills sufficient to interact with multiple departments and organizational ability to manage workload.

Keywords: Sigma Inc, Plymouth , Insurance Verification Assistant, Other , Plymouth, Massachusetts

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