Insurance Verification Specialist - Cancer Care Institute

Monument Health
US - South Dakota - Rapid City
July 4, 2024

Current Employees:

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Primary Location

Rapid City, SD USA

Department
CCI Clinic

Scheduled Weekly Hour
40

Starting Pay Rate Range
$16.40 - $20.50
(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary
• This position is not remote and is located in office in Rapid City, South Dakota.*

The Patient Services Specialist expedites and enhances patient access to care by scheduling patient appointments including diagnostic services in real time and financially clear patients prior to date of service. Financial Clearance to include completing insurance verification, pre-certification, authorization, pre-registration, notification to the patient or responsible party of estimated amount due for services provided by both the clinic and the facility, and collection of prepayment.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:
• Supportive work culture
• Medical, Vision and Dental Coverage
• Retirement Plans, Health Savings Account, and Flexible Spending Account
• Instant pay is available for qualifying positions
• Paid Time Off Accrual Bank
• Opportunities for growth and advancement
• Tuition assistance/reimbursement
• Excellent pay differentials on qualifying positions (extra pay for working evening, nights or weekends)
• Flexible scheduling

Essential Functions:

Accurately identifies patient from the Master Patient Index, if applicable as evidenced by documentation.
Responds to telephone calls in a timely manner. Speaks with a pleasant and professional voice when on the telephone. Interprets the caller's needs and offers assistance as evidenced by observation and feedback.
Ensures all Critical Data Elements are obtained and input correctly in required areas to include multiple EMR's for efficient, accurate and complete billing.
Schedules appointments promptly and courteously and makes all attempts to meet the patient's expectations. Obtains patient information (name, date of birth, diagnosis, ordering physician). Indicates patient information on the patient schedule.
Communicates the need for preauthorization for exams prior to completion of exam scheduling.
Demonstrates knowledge of third party payer information, including Medicare, Medicaid, VA, Tricare/UHC and commercial payers, to ensure compliance with rules and regulations to ensure accurate reimbursement. Utilizes available tools to identify third party payers and verifies current insurance eligibility in the most efficient manner possible. This could include Passport, EHR, insurance websites, telephone, or fax.
Contacts third party payer and verifies coverage, obtaining preauthorization when required.
Contacts patients to discuss estimate of amount due in a friendly and professional manner.
Collects prepayments prior to services provided, amount to be determined based on percentage of amount due. Records any collected payment according to department policies and procedures.
Identifies patients at high risk for financial clearance and patients requesting assistance, assist patient in completing financial assistance paperwork, provide counseling for payment arrangement and act as a liaison between the patient and patient accounts department. Efficiently and effectively communicates with clinical staff to include nurses and providers regarding delays in clearance process which may postpone patient care.
All other duties as assigned.

Additional Requirements

Required:
Education - High School Diploma/GED Equivalent in General Studies

Preferred:
Experience - 1+ years of Billing/Collections Experience; 1+ years of Customer Service Experience; 1+ years of Scheduling Experience
Education - Associates degree in Healthcare

Physical Requirements:
Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.

Job Category
Patient Services

Job Family
Patient Support10 Monument Health Rapid City Hospital, Inc.

Make a difference . Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Read the full job description and apply online on the recuiter's web-site

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