As a compassionate non-profit organization since 1983, Chapters Health System is committed to enhancing the lives of those affected by advancing age or illness. Through our comprehensive system of healthcare choices, we deliver expert care and heartfelt support to guide the community during the aging and end-of-life journey. From hospice and palliative care for adults and children suffering with life-limiting illnesses to in-home and community-based services for frail but independent seniors, Chapters Health offers a wide range of support services along life's ever-changing landscape.
Role: The primary functions of an Insurance Verification Representative are the daily management of the assigned portion of the referrals/admissions, typically allocated based on teams. Basic responsibilities include daily verification of Hospice benefits for all referrals and admissions from all payers. The Insurance Verification Representative may also perform other duties as assigned, including but not limited to special patient accounting projects, data entry and cash applications.
- High School Diploma.
- Minimum one year of medical billing and collection experience required.
- Knowledge of third party billing and state and federal collection regulations preferred.
- Ability to prioritize and multi-task independently with little supervision.
- Must be self-motivated, service oriented and have excellent written and oral communication skills.
- Requires typing and data entry skills with emphasis on accuracy.
- Valid drivers' license and automobile insurance.
- Performs verification functions for all payers for each referral and admission to ensure complete and accurate information is recorded in Solutions on the patient account.
- Process account set-up for each admission ensuring the accuracy of paysource.
- Coordinate Face to Face activities with Enrollment Center, Admissions Departments and Compliance
- Work directly with third party payers, internal and external customers, and other contract clients toward effective and efficient processes in accordance with departmental policy and procedures.
- Maintains a thorough knowledge of third party reimbursement requirements for payers assigned for handling.
- Utilizes all resources available, including electronic inquires to verify eligibility, benefits and claim status.
- Exercises good judgment towards account resolution and documents all activity on account in a clear, accurate and consistent manner utilizing appropriate online system.
- Work Medicare non-recert report and DDE verification report monthly and provide required information.
- Demonstrates excellent customer service skills when responding to incoming or outgoing calls in a most courteous manner providing clear and appropriate information as needed.
- Generate and key 81A's as required.
- Advise team lead and/or supervisor of any billing errors, payer trends in claims processing, denials or payment fluctuations, to ensure proper handling and escalation as necessary.
- Attends and actively participates in departmental meetings.
- Meet departmental productivity and quality assurance standards in accordance with departmental policies.
- Responsible for special projects and all other duties as appropriate under supervision of Patient Accounts management.