Insurance Clerk - Union Hospital - Terre Haute, IN
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Files various insurance claims; i.e. primary, secondary, and disability.
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Sends requested additional information to various insurance companies.
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Assists patients and insurance companies on the phone with insurance problems or questions.
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Assists patients at the window/counter.
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Sets up insurance.
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Answers insurance inquiries.
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Verifies insurance eligibility.
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Obtains necessary referrals and authorizations.
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May review Medicare, HMO, and EOBs for correct payment and information.
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May prepare related types of letters:
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Referral letters
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Return to work letters
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Medical necessity letters
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May complete necessary nursing home request letters.
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May process missing ticket reports.
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Works outstanding invoice/reports, contacting insurance companies regarding claim status.
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May adjust and/or correct fees, procedures, and diagnosis; i.e. HMO, etc.
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Audits patient accounts.
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Utilizes Union Hospital computer system to print patient information for distribution to the department.
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Posts Hospital charges.
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Requests or obtains EOBs for inquiry purposes.
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Requests referral forms.
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Attends insurance meetings, both in office and outside of office.
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Interacts with physicians to obtain proper diagnosis for insurance purposes.
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Sets up new patient insurance information.
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Sets up insurance and employers into the computer master file.
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Assists patients on indigent care programs in obtaining goods and services.
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Calls specialists with referral numbers.
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Calls for precertifications and authorizations.
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Performs other job related duties as assigned.
CUSTOMER SERVICE STANDARDS
Customer Service (a customer is anyone, internal or external, with whom you come into contact, i.e., co-workers, patients, visitors, etc.)
1)
Attitude
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Promptly responds to customers in a friendly manner, listening carefully and using customer’s name.
Every customer greeted with a smile.
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Is consistently courteous and helpful.
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Is considerate, sensitive and tolerant of all customers and their differences.
2)
Professionalism
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Answers telephone promptly, consistently identifies self and department and returns calls promptly.
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Is responsible for ensuring that all patient, facility and employee information is not compromised.
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Respects privacy of all by eliminating gossip and unprofessional talk.
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Displays a professional appearance at all times, including appropriate dress as defined in employee handbook and wearing visible identification badge at all times.
3)
Commitment
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Welcomes and supports all customers.
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Displays follow through at all times to ensure customer satisfaction.
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Is honest in all interactions
4)
Ownership
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Takes pride in organization as if you own it, speaks positively about the organization and practices safety as a daily work habit.
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Continually seeks new and better ways of doing things.
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Supports and participates in various teams, events and activities provided by the Clinic.
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TRAINING, EXPERIENCE, SKILLS AND ABILITIES NEEDED:
1.
Working grasp of standard written and verbal English, good spelling, accomplished at basic business math.
2.
Must meet and deal successfully with a wide variety of people.
3.
Should be knowledgeable of ICD-9, CPT coding.
4.
Medical terminology helpful.
5.
Should possess good telephone skills.
6.
Must possess one year of insurance experience in a medical office setting.
PHYSICAL DEMANDS:
While performing the duties of this job, the employee is regularly required to talk or hear.
The employee frequently is required to sit and use hands to finger, handle, or feel objects, tools, or controls.
The employee is occasionally required to stand, walk, and reach with hands and arms.
Employee must frequently lift and/or move up to 10 pounds.
Specific vision abilities required by this job include close vision and the ability to adjust focus.
OHSA III Classification
TOOLS AND EQUIPMENT:
1.
Computer, calculator, and general office equipment.
EOE/M/F/Vet/Disabled
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