Insurance Verifier

At United Surgical Partners International, Inc., our mission is to provide first-class surgical services for the local community in a safe, comfortable and welcoming environment; one in which we would be happy to treat our own families.
Facility: Hinsdale Surgical CenterJob Category: Business OfficeDate Posted: 6/29/2006Minimum Experience: 1Preferred Experience: 3Job Description: United Surgical Partners International is a publicly traded company that specializes in the development and operation of Ambulatory Surgical Facilities in the U.S. and the UK. We provide first-class surgical services for local communities and recognize our employees are our number one assets.Job Summary: Contacts all insurance companies to verify description of patient(s) medical plan benefits. Interacts with physicians personnel and patients regarding financial issues, assures appropriate payment for procedures.Essential Duties and Responsibilities: Include the following. Other duties may be assigned.
Scheduling, front desk.
Contacts all insurance carriers per patient, to insure proper coordination and reimbursement of benefits.
Breaks down managed care contract reimbursements and estimates patient(s) financial responsibilities.
Assess patients estimated out of pocket expense, makes financial arrangements in lieu thereof. Mails out financial letter.
Informs patients of financial obligations prior to date of surgery.
Maintains out of pocket expense log (accrual report) for receptionist and/or business manager.
Backs-up for Scheduling Coordinator: Schedule surgeries, coordinates schedule between Surgery Center and doctor’s offices.
Gathers all detailed information for the patient’s chart, such as type of procedure, supplies, special equipment required, insurance information, etc. Enters all patient information in computer system.
Schedules all surgical anesthesia services required according to doctor preference and availability.
Crossed trained to fill in and effectively perform all other job descriptions
Confers with O.R Nurse Manager, Charge Nurse and /or Administrator to determine status of scheduled surgeries. Alters schedules to meet unforeseen conditions.
Works closely with the Administrator and CSO Credentialing person when maintaining approved privileges, suspension letters, reinstatement letter, when documents are updated, etc.
Interacts appropriately and effectively with all patient/others regardless of age or ethnic background.
Initiates safe practices and is knowledgeable about current center policies and procedures. Specific procedures and practices related to pain management, abuse and neglect, sentinel events and response, variance reporting, response to sentinel event alerts, participation in root cause analysis and other key policies and procedures is required.
Assists with environmental hazard and infection control surveillance participate in emergency preparedness drills.
Follows all equipment safety guidelines and is personally responsible for knowledgeable use and care for all business equipment.Our Insurance Verifier enjoys the following:
Interaction with several different levels of people
Self-paced environment
No weekends/holidays
Variety of tasks
Builds relationships with physician officesAnd possible career path to Scheduler!!USPI's EDGEUnited Surgical Partners International is committed to continuously learning and sharing improvements in processes so that Every Day Giving Excellence in caring for our patients is our top priority.USPI's EDGE provides employees the tools to exceed the key requirements of our patients, surgeons, payers and employees. EDGE is a systematic process that measures our performance of the key requirements, shares those process differences that improve our performance, and monitors our improvements.
REQUIREMENTS
Qualification Requirements: To perform this job successfully, and individual must be able to perform each essential duty satisfactory. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Education and/or experience: High School education and/or equivalent; up to one year of related experience or training or equivalent combination of education and experience. Within the first 90 days of employment and annual thereafter, must complete EDGE training and be able to recite program objectives, key requirement, process steps and goals as outline below.