Patient Service Rep - Insurance Verification Specialist - Outpatient Rehab

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.

In office Virginia Beach - Town Center Location (this is not a hybrid position)

+ Hours: Monday - Thursday- 730a- 430p / Friday- 730a- 200p = 40 hours

+ Strong attention to detail, strong multi-tasking skills, and written communication skills.

+ Prolong sitting at a desk working on a computer.

+ This position is NOT coding, billing, or claims.

+ Candidates having knowledge insurance payor verification/ benefits - contacting/ online insurance payor obtaining eligibility benefits / authorization information.

The Insurance Verification Specialist supports outpatient rehab office staff by researching and verifying patient health insurance eligibility, interpreting insurance benefits for a specific service, and documenting this information into EMR system. Insurance verification specialist identifies when insurance authorization is required, initiates prior authorization request, and submits supporting clinical documentation to obtain approval for services provided by outpatient rehab clinics.

Research and verify patient health insurance coverage and eligibility. Register patient coverage accurately within EMR to ensure timely billing and reimbursement from payer

Obtain and interpret specific program benefits under patient health insurance plan by using online portals or phone calls to payer

Concisely and accurately document patient benefit information within EMR system to generate patient estimates

Effectively communicate benefit information to patients, as needed. Answer detailed patient questions regarding out-of-pocket costs, as indicated under their specific insurance plan

Initiate prior authorization requests with insurance payer, submit clinical documentation that supports medical necessity for request and follow up on authorization status prior to patient's first scheduled visit

Maintain clear, timely communication with front office staff regarding insurance benefit barriers that may prevent patient conversion, or delay prior authorization approval prior to first patient visit

In office position full time Monday - Friday

**Minimum Years and Type of Experience:**

1 year of experience in insurance verification

**Other Knowledge, Skills and Abilities** **Required:**

+ Comprehensive understanding of insurance eligibility and coverage requirements, contract benefits and medical terminology. Customer focused with strong interpersonal skills, courtesy and tact with patient and rehabilitation staff. Work requires the ability to ensure the confidentiality and rights of patients and the confidentiality of hospital and departmental documents. Must be able to demonstrate a working knowledge of personal computers and proficient in computer applications and other electronic technologies. Must demonstrate a positive and professional demeanor along with strong verbal and written communication skills, including proper phone etiquette. Understand and follow HIPAA regulations. Able to organize workload and manage time efficiently. Must be able to handle potentially stressful situations and multiple tasks simultaneously. Must be able to successfully complete additional job-related training when offered. In office position full time.

Many of our opportunities reward* your hard work with:

Comprehensive, affordable medical, dental and vision plans

Prescription drug coverage

Flexible spending accounts

Life insurance w/AD&D

Employer contributions to retirement savings plan when eligible

Paid time off

Educational Assistance

And much more

*Benefits offerings vary according to employment status

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health - Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com . If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com