SPECIALIST-PATIENT FINANCIAL PRE SERVICES

POSITION TITLE:                          Authorization and Insurance Verification Specialist 

DEPARTMENT:                              Patient Financial Pre-Services 

FLSA STATUS:                              Non-exempt 

REPORTING RELATIONSHIP:     Manager, Patient Financial Pre-Services

Job Summary: Provides accurate and timely insurance verification of eligibility and benefits. 

Essential Functions:

• Consistently uses an outward mindset and puts forth exemplary effort in accomplishing his/her goals and objectives in a manner that helps others to achieve their goals and objectives.
• Provides accurate and timely insurance verification for ancillary, surgical, inpatient, and observation services.
• Obtains benefit and any required pre-authorization and/or notification information for all services verified.
• Follows appropriate point of service collection and notification processes.
• Verifies insurance for multiple departments as assigned and obtain the authorization if needed.
• Demonstrates accuracy in gathering information and inputting data in all phases of insurance verification and the updating process.
• Calculates estimated point of service amounts

Minimum Qualifications: 18 years of age. Two (2) years’ experience related to healthcare insurance verification and/or billing. 

Knowledge, Skills & Abilities: Knowledge of clinical and medical terminology; computer skills.  Strong verbal communication, interpersonal, organizational, customer service, and critical thinking skills. Ability to problem solve, handle conflict, and adapt to frequent change. Ability to interpret insurance records and related documentation. 

Working Conditions:  Work is generally performed within an office environment, with standard office equipment available.

Physical Requirements:  Constantly sit, see/visual acuity, handle/grasp/feel, talk/hear.  Occasionally lift/carry 1 to 25 lbs.

The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.