Insurance Verification Representative, Danbury Surgical Center
Company: Surgery Care Affiliates
Location: Danbury
Posted on: June 23, 2022
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Job Description:
**Overview****Join Our Amazing Team!** **Danbury Surgical
Center** Affiliates of SCA has an exciting **Insurance Verification
Position** opportunity wed love to hear from you! If you are
interested in becoming part of an organization that is helping to
improve healthcare, then this is the place for you. Your experience
in insurance verification is exactly what we are looking for!Our
team members enjoy the following perks:+ Exceptional benefits
(medical, dental, vision, 401K) that begin the first day of
employment+ Positive, friendly environmentSurgical Care Affiliates
(SCA) is transforming specialty care in our communities. We
relentlessly create value by aligning physicians, health plans and
health systems around a common goal: delivering exceptional care
and healing to our patients and communities we serve. We are driven
to achieve the quadruple aim in health care: high quality outcomes
and a better experience for patients and providers, all at a lower
total cost of care. As a national leader in surgical care, SCAs
11,000 teammates operate more than 260 surgical facilities that
serve over 1 million patients per year. For more information on
SCA, visit www.scasurgery.com .**Accountabilities /
Responsibilities****Responsibilities --**Insurance Verification:+
Verify that sufficient information is available for accurate
verification and eligibility. This step may require direct contact
with the physician office and/or the patient.+ Determine if a
secondary insurance should be added to the patient account ensuring
theappropriate payer is selected for Primary insurance.+ Utilize
the centers selected vendor for claims and eligibility and/or
individual payer websites to obtain eligibility, benefits and/or
pre-certs and authorization information.+ Enter the patient
insurance information into patient accounting system ensuring the
selection is the appropriate payer and associated financial class.+
When the patients insurance is Out of Network notify the manager
immediately. Follow the Policies and Procedures when accepting Out
of Network payers.+ SCAs goal for each patients insurance
verification is complete and accurate. The insurance verifier will
document the findings in the patient account and will contact the
patient with either estimated co-insurance, co-pay and or
deductible amounts due on or before the date of service as
applicable+ The Insurance Verifier will call each patient as part
of center compliance with CMS Conditions for Coverage guidelines in
contacting patients prior to the date of service to review,
Physician Ownership, Advance Directives and Patient
Rights.Authorization:+ Obtain authorizations from insurance
companies/physician offices. Ensure complete and accurate
information is entered into the patient accounting system and the
procedure scheduled, date of service and facility name are on the
authorization. Ensure the authorization has not expired.+ Enter
authorization into patient accounting system. Include the name/CPT
codes effective date of theauthorized procedures.+ Ensure high cost
implant/supply or equipment rental is included on authorization.+
Check insurance company approved procedure lists/medical policies.
If procedure is not payable, notify patient. If patient wants to
proceed, obtain signature on MedicareABN or other non-covered
notification form.Financial Orientation:+ Calculate co-pay, and
estimated co-insurance due from patients per the individual payer
contractper the individual payer contract and plan as applicable.+
Acceptance of in-network benefits for out-of-network payers must be
pre-approved bySCA Compliance Dept.+ Be familiar with individual
payer guidelines and the process of collecting over the
counterpayments/deductibles/copay/co-insurance. Knowledge of payer
contracts including Medicare,Medicaid and other government
contracts and guidelines and workmens compensation fee schedule.+
Contact the patient and communicate the center financial
policy**Qualifications**+ Bachelors degree preferred but not
required+ Experience checking authorizations+ Must be experienced
withcptcodesand medical terminology+ Healthcare experience a must+
Background in healthcare insurance contract, verifying
co-insurance, pre-registration and deductibles preferred+ Detailed
and able to work in a high production
environmentmyscabenefits.comSCA requires all new hires and
employees to report their COVID-19 vaccination status. SCA will
also adhere to all federal, state and local regulations as well as
related company policy. When required, SCA will obtain necessary
proof of vaccination prior to employment to ensure compliance.As a
representative of Surgical Care Affiliates, all comments,
attitudes, actions, and behaviors have a direct impact on the
Facilitys success. Interaction with patients, families, physicians,
referral sources, affiliated schools, visitors, volunteers,
co-workers, supervisors, vendors, etc. must be in a manner that is
friendly, supportive, courteous, respectful, cooperative, and
professional. This behavior should promote an atmosphere of
teamwork, a culture of safety, and in accordance with SCA Core
Values.EEO StatementWe value Diversity, Inclusion, and Belonging at
Surgical Care Affiliates: SCA is an Equal Employment Opportunity
employer, and all qualified applicants will receive consideration
for employment without regard to race, color, religion, sex
(including pregnancy), age, national origin, disability and genetic
information, or any other characteristic protected by
law.UnitedHealth Group is a drug - free workplace. Candidates are
required to pass a drug test before beginning employment.**Job
Locations** _US-CT-Danbury_**# of Openings** _1_**Category**
_Technician/Clinical Unlicensed_**System ID**
_22091_**Telecommute** _No_**Employee Type** _Regular_**Employee
Status** _Full-time_**Group Name** _Acela_
Keywords: Surgery Care Affiliates, Danbury , Insurance Verification Representative, Danbury Surgical Center, Other , Danbury, Connecticut
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