INSURANCE VER REP Job at Prairie St. John's, Fargo, ND

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  • Prairie St. John's
  • Fargo, ND

Job Description

Responsibilities

The Insurance Verification Clerk is responsible for verifying all healthcare insurance benefits for patients that are admitted either through an initial needs assessment evaluation or by direct admit. Ensures benefit information is communicated to other appropriate departments.  Ability to apply common sense and understanding to carry out instructions furnished in written or oral form.  Able to deal with problems involving several concrete variables in standardized situations and will refer complex issues to the Business Office Director for clarification and/or resolution. 

Primary Job Responsibilities:

  • Obtains insurance verification/benefits information for all patients admitted for all levels of care and enters information into MS4
  • Reviews current census daily for all levels of care
  • Reviews the calendar daily for assessments that insurance information needs to be verified
  • Follows up on admissions by entering information into MS4 for all areas to access
  • Researches insurance benefit information unique to an insurance policy to clarify coverage, network affiliation and MH/CD care management authorization contact
  • Advises patient or family of their benefits and patient responsibility
  • Acts as a back up for the Financial Counselor
  • Obtains signed payment arrangements, medical assistance applications or Personal Payment Plan forms
  • Follow-up with all insurance eligibility benefit coverage for patients as they transition from one program to another and communicate most current benefit by updating information in MS4
  • Follow-up on all questions regarding patient benefits or managed care referrals as needed
  • Keeps a record of insurance information for patients accessed, but not admitted
  • Performs various other duties as assigned or as requested

Qualifications

Position Requirements: The position requires completion of a high school diploma or general education degree (GED) and 1 year related experience.  Previous experience with insurance claims/verification, collections, or patient accounting is preferred.  Experience with Microsoft Office products required.  General knowledge of insurances desired.

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