Overview:

We are seeking an Insurance Eligibility Verification Specialist to verify patient insurance eligibility with payers, and obtain and update patient registration (demographic and insurance) information. The role also involves obtaining referrals and insurance authorizations/pre-certifications prior to the patient's date of service, accurately documenting, and assigning referrals and authorizations in EPIC.

Key Responsibilities:

• Verify insurance eligibility for all new and return patients according to policy and procedure.
  • Use automated insurance plan eligibility databases.
  • Call insurance plans or patients if no coverage is found in EPIC.
  • Correct all insurance coverage information as necessary.
• Perform "check-in, no visit" to pass updated coverage information to Medipac.
• Communicate with check-in staff to view and update the patient's insurance card information if unable to verify eligibility.
• Complete at least 100% of assigned appointments daily.
• Register patients in the EPIC Scheduling/Registration system.
• Ensure all patient demographic and insurance information is accurate and updated according to VMG policy and procedure.
• Notify appropriate individuals of duplicate accounts or accounts containing incorrect coverage.
• Notify appropriate individuals of all transplant accounts and their claims addresses.
• Record all transactions on the daily work log per protocol.
• Answer telephones, deliver messages, and clear all voice mail daily.
• Communicate graciously and clearly with callers, taking complete messages with necessary details.
• Provide telephone coverage between 8 am and 5 pm.
• Obtain required authorizations for managed care patients and transmit PCP authorizations to specialty practices.
• Run EPIC referral/authorization reports as needed to ensure patient visits are authorized before their appointment date.

Qualifications:

• Patient registration experience
• COVID vaccination

Schedule/Shift:

• 4 ten-hour shifts per week
• Scheduled every other weekend
• Open to working 1-2 holidays per year
• Schedule provided weeks in advance
• Shift start time is 12 am CST