Insurance Verification Spec

Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for world-class health care in Palm Beach County and the greater Treasure Coast.

Outstanding physicians, state-of-the-art facilities, innovative techniques and a commitment to serving the community enables Jupiter Medical Center to meet a broad range of patient needs. Jupiter Medical Center is the only hospital in Palm Beach, Martin, St. Lucie and Indian River counties to receive a 4-star quality and safety rating from the Centers for Medicare & Medicaid Services (CMS).

Education

• High school graduate or equivalent
  
  

Qualifications

• Enthusiastic, friendly, patient focused customer service skills.
• Exemplary communication skills, written and verbal – must be comfortable speaking to patients via phone and successfully communicate pertinent information.
• Professional, effective communication skills required to contact insurance companies to obtain patient benefits.
• Must be a team player with ability to collaborate interdepartmentally and with clinical staff.
• Capacity to multi-task with computer programs while providing patients the highest level of care and attention.
• Works well in a team environment to accomplish common tasks to solve problems and enhance the smooth and efficient flow of the department.
  
  

Experience

• Minimum of 1 year experience with hospital insurance plans including Medicare, Medicaid, HMO's and PPO's.
• Excellent typing and computer skills.
• Familiarity with area managed care plans and contractual terms.
• Ability to self-direct and exercise independent judgment in situations requiring follow-up and discussions with clinical staff and/or other areas of Patient Access to ensure completion of required pre-arrival information to ensure enhanced customer service.
• Minimum of 1 year of specialized training in a health care setting with demonstrated knowledge of insurance verification and working knowledge of authorization and pre-certification process preferred.
• Familiarity with medical terminology.
  
  

Position Summary

The Insurance Verification Specialist will be responsible for delivering a dynamic customer experience to all customers and demonstrate a strong commitment to service excellence.

The Insurance Verification Specialist initiates contact with insurance companies for verification of benefits.

• Utilizes electronic scheduling/pre-registration/financial systems, payer’s websites, and recorded calls to validate patient’s health coverage and benefits.
• Review and verify all insurance plans and confirm patient’s eligibility and benefits.
• Communicate with insurance carriers for insurance verification, obtaining patient benefits and/or follow up.
• Verify whether the plan coverage is Primary or Secondary; HMO, PPO or Commercial Carrier Insurance
• Verify plan coverage including deductibles and co-pays and the status of payment requirements.
• Verify the out-of-network requirements/benefits for each patient.
• Verify insurance for emergency and walk-in patients as requested.
• Maintain proper insurance verification documentation in the patient’s medical record.
• Input or update any demographic, insurance information, referrals, patient management, documentation into electronic file.
• Contacts and communicates all applicable insurance deductible, co-pay, arrival and procedure information and instructions to the patient prior to arrival.
• Identify patient financial responsibilities and collect applicable payment.
• Maintains the confidentialtiy of patient’s records and any related work.
• Performs other duties as assigned.