As part of the Revenue Cycle, the Insurance Verifier is responsible for financial clearance of all patients assigned to their work list/queue. This includes but is not limited to, online eligibility, initiating precertification/authorization, obtaining benefit detail, discussing the patient responsibility prior to arrival and point of service collections. This also includes on-going support of the ancillary services; central scheduling and outpatient registration for add ons, STAT issues or accounts in questions. This role will have a very close working relationship with billing to address denials and appeals as needed.
ESSENTIAL FUNCTIONS AND DUTIES ·Run daily work list assignments from Meditech in an effort to ensure all patients are accurately reflected. Cross check this report against the online Meditech work list. ·Effective use of the online eligibility system in use including daily review of Loxogon alerts, these alerts should be corrected as close to real time as possible. ·Responsible for insurance verification, including authorization, benefits, and eligibility on all patients within the assigned work list at least 1 week prior to arrival. (Exceptions will be granted for add on cases, difficult accounts, etc...) ·Ensure an RQI (Radiology Quality Initiative) is secured on specific Blue Cross Blue Shield patients requiring authorization prior to services. ·Collaborates as needed with billing on denied claims and appeals in a timely manner in an effort to resolve discrepancies and expedite payment. ·Collaborates with ancillary departments and referring clinics to ensure correct services are ordered and authorized prior to the service date. ·Efficient use of the charge master within Meditech or any tool in place to determine cost of service and familiarity with contracted survives/insurances.
MINIMUM EDUCATION: HIGH SCHOOL DIPLOMA OR G.E.D EQUIVALENT
MINIMUM WORK EXPERIENCE: • A minimum of 2 years working experience with insurance precertification and financial clearance. • Prior physician/hospital scheduling experience preferred.
KNOWLEDGE & SKILLS: • Meditech (preferred B/AR, ADM and PCI modules) • MS Office (word, excel power point, access) • Familiarity with insurance contracts, terms, payment methods and authorization requirements. • Eligibility systems (Ecare/Passport, Loxogon)
Strong insurance background preferred. One year insurance pre-certification experience, medical terminology, CPT & ICD-9 Coding, and Meditech experience preferred.
Schwab Rehabilitation Hospital is a freestanding, not-for-profit, 102-licensed bed facility onChicago’s West and Southwest Side that offers comprehensive inpatient and outpatient programs foradults and children. Schwab is a proud member of Sinai Health System and the first fully licensed andaccredited rehabilitation hospital in the Midwest.Our therapists see patients through the entire continuum o...f care, from acute inpatient admissions atMount Sinai Hospital, to inpatient rehabilitation and outpatient therapy services at Schwab. We alsohave a hospital-based rehabilitation-focused short-term sub-acute unit at Schwab that provides boththerapy and nursing services with exceptional outcomes.Our rehabilitation team takes a holistic, interdisciplinary approach to address the physical, cognitiveand psychosocial needs of each patient. Each patient is assessed and provided with a personalized careplan tailored to help achieve maximal independence and function. Schwab offers seven treatmentgyms featuring private treatment rooms, a warm-water indoor therapy pool, and an award-winningtherapeutic roof top garden.