<p>The Insurance Follow Up/Verifier is responsible for all inpatient/outpatient areas, including but not limited to: scheduled surgeries, the inpatient census reports, on-line systems provided by multiple payers to verify insurance eligibility, obtain benefits, obtain required authorizations, contact patients with financial liability, and maintain appropriate/consistent documentation on accounts worked. The insurance follow up/verifier is consistently updating patient health information to ensure insurance accuracy. Ensuring accurate and timely follow up by making calls to the insurance company regarding authorization status. The insurance follow up/verifier reviews orders prior to testing to ensure it meets medical necessity guidelines. The insurance follow up/verifier files and follows up on appeals to the insurance company.</p> <ul> <li>Responsible for verifying insurance eligibility and obtaining authorizations for office visits, diagnostic and procedural services for all Baptist Cardiology office locations. </li><li>Works closely with Baptist Medical Group Representatives, all medical facilities, insurance companies, providers, patients and family members. </li><li>Work daily reports from various systems to ensure the proper capture of all patients for verification/authorization. </li><li>Communicates directly with the patients three (3) to five (5) days prior to arrival with information about co-pay, co-insurance and deductible amounts due at time of service (makes three (3) attempts to contact patient prior to visit) and provides patients with information regarding financial arrangements and/or financial assistance when needed. </li><li>Provides patients and ordering physicians with information regarding needed authorization prior to patient's arrival. </li><li>Files and follows up on appeals to the insurance companies. Communicates appeal information to the providers and patients. </li></ul> <p>Minimum Education</p> <ul> <li>High School Diploma or Equivalent Required </li></ul> <p>Minimum Work Experience</p> <ul> <li>6 months customer service experience preferably in a Health Care/office setting Required </li></ul> <p>Required Skills, Knowledge and Abilities</p> <ul> <li>Ability to provide excellent customer service. </li><li>Knowledge of medical terminology as they apply to specialty. Must be able to use a multi-line phone system, scanner, computer, calculator, fax, copier and other office tools needed to perform daily job duties. </li><li>Ability to maintain confidentiality of patient information in accordance with HIPPA guidelines. </li><li>Must have the ability to communicate effectively, both written and orally, when in contact with co-workers, management, physicians, patients and internal/external customers. </li><li>Ability to handle complaints and request in a professional calm manner. </li><li>Confident with organizational ability and excellent multi-tasking skills. </li><li>Must have good team member skills and function well under pressure. </li><li>Skilled and competent with use of computers and related software applications. </li><li>Ability to function in a fast paced, often stressful environment while maintaining a respectful, caring, calm, professional manner at all times. </li><li>Customer focused. </li></ul>