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Insurance Verification Specialist
- Emerus Holdings Inc
- Shift Type
Emerus is a nationally recognized, innovative leader in the delivery of inpatient, surgical, and diagnostic medical health care. Specializing in the identification, development and management of improved-access community medical facilities, Emerus provides cost effective, scalable growth opportunities to large-scale, national health care systems throughout the United States.
By providing operationally efficient facilities and focused alignment with current health care trends, Emerus’ community-based hospitals prioritize limited inpatient stays, efficient emergency rooms and cost effective pricing in a smaller campus setting. Based in The Woodlands, Texas, Emerus has more than 1,000 employees, with expert concentrations in over 20 different fields throughout the medical industry.
The purpose of this position is to complete eligibility and benefit verification to ensure the timely and accurate submission of claims (i.e. insurance companies, Medicare and Medicaid, employers, individuals, etc.) for health services provided by the company.
Essential Job Functions
- Complete daily eligibility and benefit verification for all facilities utilizing best practice processes
- Document benefits on the patient account for use by other team members
- After eligibility completion, prepare accounts for billing
- Review and correct all claim rejections regarding eligibility
- Review exception and discharge not final bill reports for outstanding MVA and WC information
- Complete verification of insurance as patients provide updates to Customer Service or via mail
- Follow-up and investigate any billing errors returned from payers. Work with respective team members/supervisors for resolution.
- Review and update demographic/guarantor/insurance data obtained in the registration process as necessary
- Additional billing type functions as assigned
- High School Diploma or GED, required
- Two years insurance verification experience, required
- Expert knowledge of various payers and payer insurance cards, required
- Knowledge of Microsoft Office Tools (Microsoft Word, Excel and Outlook), required
Position requires fluency in English; written and oral communication