Insurance Verifier - Saint Anthony Hospital

Insurance Verifier – Admitting Department

Rotating Shift, Full Time

Saint Anthony Hospital is a diverse and community-centric organization your career can thrive in, while addressing the health and wellness challenges that families in our neighborhood face. Our employees deliver on our mission and achieve success by working together to provide excellent customer service and patient care.

As part of Saint Anthony Hospital’s commitment to providing the highest quality health care, we will be building a new state-of-the-art hospital to serve as an anchor to the Focal Point Community Campus. Learn more at focalpointchicago.org.

Position Purpose:

• Contact insurance companies to secure accounts prior to services being rendered.
• Obtain authorization and/or referrals as required.
• Initiates and processes the pre-admission and pre-registration function for patients entering the organization for surgery and ancillary services.

Essential Functions:

• Reviews preadmission/pre-registration files/reports daily and conducts telephone calls to various insurance payers as well as to appropriate patients at least 72 hours prior to date of service. Follows up with patient until payer information has been received, deposit made, and/or payment arrangements made according to policy.
• Verifies insurance benefits assigned, accesses third party intermediary systems for eligibility status, acquires authorization approvals, contact primary care physician when necessary to initiate pre-certification or authorization for services, and documents all updated financial/demographic information into the hospital system after reviewing the financial account for status of all necessary information.
• Communicates with physicians and other medical staff for intake of medical diagnosis or procedures for patient reservations as well as interpreting physician orders for ancillary services.
• Explains financial requirements to the patients, guarantor or family members. Informs patients/family members of deductibles for elective procedures prior to date of service. Records anticipated payment patient is to bring on the day of service.
• Offers opportunities for payment, secures payment or contract for payment, refers account to Financial Counselor to initiate applications for MANG and Charity Care.
• Maintains all department logs, reports, and records, including daily and weekly management reports of work received, work completed, and work to be completed. Documents activities as appropriate in the collection notes and workstation of the system.
• Enters comprehensive registration data set into hospital system by interviewing patients in by telephone to secure demographic, clinical and financial information. Evaluates demographic and financial data for potential problems or financial risk, works to resolve these problems with medical staff, financial counselors and appropriate administrator on call.

General Job requirements:

• Knowledge of system support issues that affect billing, collection, and cash application functions.
• Knowledge of healthcare reimbursement principles.
• Knowledge of healthcare computer systems relating to patient access and patient financial services.
• 1-3 years of customer service experience
• Ability to communicate effectively
• Ability to type minimum 30 wpm

Saint Anthony Hospital Highlights:

• Saint Anthony Hospital is an independent, nonprofit, faith-based, acute care, community hospital dedicated to improving the health and wellness of the families on the West Side and Southwest Side of Chicago.
• Saint Anthony Hospital has been certified as a Primary Stroke Center by The Joint Commission.
• Saint Anthony Hospital offers competitive wages and a comprehensive benefits program for employees and their families.
• Saint Anthony Hospital employs and teaches some of the city’s brightest, most innovative resident physicians and medical students.

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