Insurance Verification and Case Costing Lead
The Hospital At Westlake Medical Center
11.2021 - Current
- .Comply with HIPAA guidelines and regulations for confidential patient data.
- Manage verification team and make sure that department has proper coverage at all times.
- Update patient records with accurate, current insurance policy information.
- Manage high-volume insurance verifications within pre-determined timeframes for productive medical operations.
- Assist patients with understanding personalized insurance coverage and benefits.
- Achieve insurance pre-authorizations to enable timely patient procedures.
- Train new staff on current, correct insurance verification procedures as well as provide continuous training to current verification staff.
- Establish and maintain relationships with insurance providers for productive communications.
- Maintain strong knowledge of basic medical terminology to better understand services and procedures.
- Make contact with insurance carriers to discuss policies and individual patient benefits.
- Assure timely verification of insurance benefits prior to patient procedures.
- Generate reports to track insurance verifications and claim progress.
- Communicate verification and authorization status updates with upper management to facilitate decision-making for patient admissions and insurance coverage.
- Perform various administrative tasks by filing, copying and faxing documents.
- Assist with case costing team to assure that scheduled cases are profitable for the facility.
- Assist with new service lines to make sure that the verification process runs smoothly.
- Assist in training front desk registrars to identify insurance payers so that they are able to load properly in our system.
