To verify and monitor patient insurance benefits, authorization, and enter information required into computer.
- Verifies and obtains all authorizations and necessary pre-certifications from insurance companies.
- Informs Supervisor about patients who are underinsured or without insurance
- Perform verification of Medicare coverage and limits on all Medicare accounts of inpatients.
- Communicates benefit information with attending physician.
- Determines patient review dates according to established diagnostic criteria.
- Maintains accurate patient insurance information.
- Keeps informed of all new registration procedures.
- Performs quality reviews on all financial files on a daily basis.
- Participates in Discharge Planing Meeting Daily.
- Maintains established departmental policies and procedures, objectives, performance improvement program, safety environmental and infection control standards.
- Notifies supervisor concerning admissions that do not meet the hospital financial policy criteria.
- Analyzes insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of patients.
- Participates in educational programs and in-service meetings as required.
- Prepares statistical reports.
- Performs all related duties as requested or assigned.
- Keeps informed on the ABaker Act@ and Mental Health related laws.
- Strives to communicate effectively and courteously with all groups as delineated by interactions.
- Immediately reports to supervisor any occurrences or situation that are out of the norm.
- 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.
High School require
Preferably Associate degree