Job details

Pre-Registration/Insurance Verification Representative (Central Insurance Verification) Part time

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Position Title:

Department:

Admitting

Job Description:

General Description: Responsible for timely and accurate pre-registration and insurance verification. Accurately interprets managed care contracts.

Essential Responsibilities:

Performs pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services
Follows scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information therein
Contacts physician to resolve issues regarding prior authorization or referral forms
Assigns plans accurately
Performs electronic eligibility confirmation when applicable and document results
Researches Patient Visit History to ensure compliance with payor specific payment window rules
Completes Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module
Calculates patient cost share and be prepared to collect via phone or make payment arrangement
Contacts patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment
Receives and records payments from patient for services scheduled.
Utilizes appropriate communication system to facilitate communication with hospital gatekeeper
Performs insurance verification and pre-certification follow up for prior day’s walk in admissions/registrations and account status changes by assigned facility
Communicates with hospital based Case Manager as necessary to ensure prompt resolution of pre- existing, non-covered, and re-certification issues
Utilizes Meditech account notes and Collections System account notes as appropriate to cut and paste benefit and pre-authorization information and to document key information
Meets/exceeds performance expectations and completes work within the required time frames
Implements and follows system downtime procedures when necessary
Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”

General Responsibilities:

Other duties as assigned

Minimum Qualifications:

Education: High school diploma or GED required

Experience: At least three years of insurance verification experience preferred

License(s)/Certification(s)/Registration(s) Required: N/A

Knowledge, Skills and Abilities:

Communication - communicates clearly and concisely, verbally and in writing
Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
Interpersonal skills - able to work effectively with other employees, patients and external parties
PC skills - demonstrates proficiency in PC applications as required
Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately

Current OU Health Employees - Please click HERE to login.

OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.

Average salary estimate

$37500 / YEARLY (est.)

min

max

$30000K

$45000K

If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.

What You Should Know About Pre-Registration/Insurance Verification Representative (Central Insurance Verification) Part time, OU Medicine

Are you ready to become a key player in the healthcare field? Join OU Health as a Pre-Registration/Insurance Verification Representative (Central Insurance Verification) Part-time! This is a fantastic opportunity for someone who enjoys working in a fast-paced, virtual environment and helping patients navigate their insurance needs. In this role, you will be responsible for timely and accurate pre-registration and insurance verification for both inpatient and outpatient services. You'll have the chance to utilize your communication and interpersonal skills while ensuring patients receive the information they need about their insurance coverage. Your day will be filled with contacting physicians to resolve issues, performing electronic eligibility checks, and calculating patient cost shares. We are looking for someone with at least three years of experience in insurance verification, who can navigate Meditech systems effectively and demonstrate an excellent understanding of organizational policies. By joining our team, you’ll not only enjoy a supportive work culture but also have access to a comprehensive benefits package, including medical and dental plans, PTO, and a 401(K). If you're ready to make a difference, we want to hear from you!

Frequently Asked Questions (FAQs) for Pre-Registration/Insurance Verification Representative (Central Insurance Verification) Part time Role at OU Medicine

What are the main responsibilities of a Pre-Registration/Insurance Verification Representative at OU Health?

As a Pre-Registration/Insurance Verification Representative at OU Health, you will perform essential duties such as conducting timely pre-registration and insurance verifications, interpreting managed care contracts, and calculating patient cost shares. Your role will also include contacting patients and providers to obtain necessary documentation and ensure compliance with payment rules.