Responsible for obtaining information on patient's eligibility status with insurance companies to ensure proper coverage and payment for services—while providing exceptional customer service. Responsible for assuring appropriate insurance verification, prior approvals, and all authorization requirements are obtained prior to the patient's arrival for surgery, during the patient's hospitalization, and after discharge to assist our patients with their insurance needs. Communicate with other departments including admitting / registration, financial counseling, and utilization review. Must understand Managed Care, Government and Commercial insurance benefits and be able to obtain coverage / benefit information timely and accurately. Has a working knowledge of the policies and procedures. Participates in hospital in-service programs as required.
High school diploma/GED required
1 Year of Insurance and/or pre-certification required
1 Year Computer proficiency in Microsoft Office Required
1 Year Medical Terminology Required
1 Year Patient access experience in pediatric hospital/clinic setting Required