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Insurance Verification Specialist

Pay Range: Min: $17.16 Mid: $21.45. Pay is based upon relevant education and experience.
 
POSITION PURPOSE:
Provide patient data management and insurance verification/prior authorization of Vail Health Hospital services in order to support Vail Health internal department functions and the overall fiscal health of Vail Health Hospital. Provide education to internal and external clients on insurance benefit programs, contracts, and financial liabilities. Act as a mentor, trainer, and resource to the department.
 
ESSENTIAL JOB FUNCTIONS:
  1.  Coordinate, obtain, and manage accurate patient demographics for registration and management of hospital systems.
  2. Maintain and update accurate insurance demographics to ensure clean claim.
  3. Perform insurance verification.
  4. Obtain prior authorization from insurance company in alignment with scheduled procedure.
  5. Collaborate with Patient Financial Services to perform appeals process for claims denied due to missing prior authorization.
  6. Clearly and effectively communicate with internal/external customers in a time sensitive manner in order to facilitate and/or provide excellent customer service.
  7. Request payment of financial responsibility from patient/guarantor.
  8. Post and reconcile outpatient payment batches.
  9. Role model the principals of a Just Culture.
  10. Perform other duties as assigned. Must be HIPAA compliant.
This description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

 

MINIMUM QUALIFICATIONS: 
 
 
Experience:
 
  • Previous hospital admissions or patient accounts office experience preferred. Completion of the Insurance Verification Representative II status required.
License(s):
  • N/A
Certification(s):
  • N/A
Computer / Typing:
  • Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc. Must be comfortable working with various computer programs, including the Microsoft Office suite.
Must have working knowledge of the English language, including reading, writing, and speaking English.
 
Education:

As a condition of employment, Vail Health requires COVID-19 vaccination of all clinical and non-clinical staff.

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