Insurance Verification Clerk - Admitting - Full Time
Company: Christus Health
Location: Longview
Posted on: October 16, 2024
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Job Description:
Description
Summary:
This position provides the insurance verification functions for all
scheduled and unscheduled patients, by contacting insurance
companies, and by utilizing our electronic eligibility system. In
addition, this position would analyze the eligibility information
and provide the estimate of the patients' portion per their
insurance contract. This position would also pre-certify patient
visits with insurance companies when appropriate, and forward
information to Case Management for clinical details.
Responsibilities:
Responsibilities:--- Determines each patient's insurance
eligibility and benefits, verifying with the insurance company,
employers, or thru our electronic system, within the departmental
guidelines --- Identifies accounts that are priority, determined by
coverage, date of service, and dollar amount of expected services
--- Verifies all insurance for scheduled and unscheduled patients
--- Obtains effective dates, correct mailing addresses, obtains
pre-certification telephone numbers, and documents all information
in the system --- Documents in the system any items that are unique
to the coverage, i. e. pre-existing, limitations, etc. with special
attention to the uninsured and credit risk accounts --- Calculates
deductible amount due, and any out-of-pocket amounts such as
co-insurance amount or co-payment amount --- Obtains
pre-certification for the current visit from the insurance company,
along with notifying Case Management if clinical information needs
to be provided to complete the pre-certification process ---
Contacts pre-certification company to obtain pre-certification
number for the visit for the hospital (not the same as the
physician's pre-certification) --- Documents the
pre-certification/reference number in the system --- Obtains
authorization for Medicaid patients when necessary --- Refers all
accounts needing clinical information to the Case Management
Department --- Corrects financial classes, insurance plans, etc.
--- to assure that the patient's financial record is correct ---
Identifies any incorrect insurance plans or financial classes, and
corrects them in the system --- Deletes incorrect or changed
insurance plans from history in the system --- Corrects Medicaid
plans to reflect appropriate plan --- If insurance is verified as
having been terminated, documents all information in the system,
and changes the accounts to self-pay
Requirements:
Education/Skills
Experience
Licenses, Registrations, or Certifications
Work Schedule:
5 Days - 8 Hours
Work Type:
Full Time
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Keywords: Christus Health, Shreveport , Insurance Verification Clerk - Admitting - Full Time, Other , Longview, Louisiana
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