Insurance Verification Clerk - Admitting - Full Time
CHRISTUS Health
Application
Details
Posted: 03-Aug-24
Location: Longview, Texas
Salary: Open
Categories:
Admin / Clerical
Internal Number: 210324
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:
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
High School Diploma or equivalent years of experience required.
Experience
1 – 3 years of experience preferred.
Licenses, Registrations, or Certifications
None required.
Work Schedule:
5 Days - 8 Hours
Work Type:
Full Time
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CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.