Insurance Clerk - Surgical Specialist of Ocala - SCA Health

Overview:

Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.

 

As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:

• We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business.
• We have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care.
• We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
• We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines.

 

The new SCA Health represents who we are today and where we are going—and the growing career opportunities for YOU.

Accountabilities / Responsibilities:

Position Description: The Insurance Verification teammate is responsible for ensuring scheduled procedures are on the patient’s insurance covered list and/or the patient meets self-pay criteria. The Insurance Verification teammate will be responsible for verifying insurance coverage, eligibility, benefits, obtaining authorizations and pre-certs as required by the individual insurance company.

 

Key Responsibilities:

• 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 the appropriate 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.
• 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 patients as needed to review patient responsibilities with regard to payment or payment plan.

Qualifications:

• All applicants must have at least 2 years’ experience preferably in an Ambulatory Surgery Center.
• Computer skills, Excel & Word programs.
• Ability to multitask
• Knowledge of Health Plans and IPA’s.
• Experience with HST and Citrix and Navinet

 

 

Min:USD $18.00/Hr.Max:USD $19.50/Hr.