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Job Description 

Insurance Verification Representative *Work-From-Home*( 08950-08949) 
Work Location: United States-Texas-Irving-PAS - Dallas
Schedule: Full-time
• Retrieve reservation/notification of scheduled admission from gatekeeper via laser printer
• Perform pre-registration and insurance verification within 24 hours of receipt of reservation/notification for both inpatient and outpatient services
• Follow scripted benefits verification and pre-certification format in Meditech custom benefits screen and record benefits and pre-certification information therein
• Contact physician to resolve issues regarding prior authorization or referral forms
• Assign Iplans accurately, via the use of the Contrak system
• Perform electronic eligibility confirmation when applicable and document results
• Research Patient Visit History to ensure compliance with the Medicare 72 hour rule
• Complete Medicare Secondary Payor Questionnaire as applicable for retention in Abstracting module
• Calculate patient cost share and be prepared to collect via phone or make payment arrangement
• Contact patient via phone (with as much advance notice as possible, preferably 48 hours prior to date of service) to confirm or obtain missing demographic information, quote/collect patient cost share, and instruct patient on where to present at time of appointment
• Receive and record payments from patient for services rendered.
• Utilize Meditech MOX communication system to facilitate communication with hospital gatekeeper
• Perform insurance verification and pre-certification follow up for prior day's walk in admissions/registrations and account status changes by assigned facility
• Communicates with hospital based Case Manager as necessary to ensure prompt resolution of preexisting, non-covered, and re-certification issues
• Utilize Meditech account notes and Collections System account notes as appropriate to cut-n-paste benefit and pre-authorization information and to document key information
• Meets/exceeds performance expectations and completes work within the required time frames
• Implements and follows system downtime procedures when necessary
• Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
• Other duties as assigned
• Communication - communicates clearly and concisely, verbally and in writing
• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
• Interpersonal skills - able to work effectively with other employees, patients and external parties
• PC skills - demonstrates proficiency in PC applications as required
• Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
• Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately
• High school diploma or GED required
• At least one year of insurance verification experience preferred
Insurance Verification Representative *Work-From-Home*
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