JOB SUMMARY:

To verify and monitor patient insurance benefits, authorization, and enter information required into computer.

 

ESSENTIAL RESPONSIBILITIES:

 

  1. Verifies and obtains all authorizations and necessary pre-certifications from insurance companies.
  2. Informs Supervisor about patients who are underinsured or without insurance
  3. Perform verification of Medicare coverage and limits on all Medicare accounts of inpatients.
  4. Communicates benefit information with attending physician.
  5. Determines patient review dates according to established diagnostic criteria.
  6. Maintains accurate patient insurance information.
  7. Keeps informed of all new registration procedures.
  8. Performs quality reviews on all financial files on a daily basis.
  9. Participates in Discharge Planing Meeting Daily.
  10. Maintains established departmental policies and procedures, objectives, performance improvement program, safety environmental and infection control standards.
  11. Notifies supervisor concerning admissions that do not meet the hospital financial policy criteria.
  12. Analyzes insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of patients.
  13. Participates in educational programs and in-service meetings as required.
  14. Prepares statistical reports.
  15. Performs all related duties as requested or assigned.
  16. Keeps informed on the ABaker Act@ and Mental Health related laws.
  17. Strives to communicate effectively and courteously with all groups as delineated by interactions.
  18. Immediately reports to supervisor any occurrences or situation that are out of the norm.
  19. Should participate in Quality Improvement activities as oriented by Supervisor.

 

 

 

SKILLS AND ABILITIES:

–     Speak clearly and listen carefully.

–     Use personal judgement and specialized knowledge to give information to people.

–     Communicate well with the diverse population we serve.

–     Ability to multitask.

–     Provide excellent customer service.

–     Provide solutions to problems.

–     Use eyes, hands, and fingers accurately while operating a switchboard or computer.

QUALIFICATION:

High School require

Preferably Associate degree