Insurance Verification

The Insurance Verification teammate is responsible for ensuring scheduled procedures are on the patient's insurance-covered list and/or the patient meets self-pay criteria. The Insurance Verification teammate will be responsible for verifying insurance coverage, eligibility, and benefits, obtaining authorizations and pre-certs as required by the individual insurance company. The teammate will verify that all scheduled procedures are on the ASC procedure listing. The Insurance Verifier will be familiar with and understand Medicare, Medicaid, other government payers, and Commercial and HMO/PPO Payers’ guidelines and principles.

The Insurance Verification teammate will be responsible for calculating co-insurance estimates per the payer contract as applicable and amounts due from self-pay patients are according to the center’s self-pay guidelines, Policies, and Procedures. The teammate will enter the verification, eligibility, and benefits information in the patient accountin...