Insurance Verification Representative (FT) - Boca Raton Outpatient Surgery & Laser Center

Company: Surgery Care Affiliates
Location: Boca Raton
Posted on: June 16, 2022

Job Description:

**Overview**Surgical Care Affiliates (SCA) is transforming specialty care in our communities. We relentlessly create value by aligning physicians, health plans and health systems around a common goal: delivering exceptional care and healing to our patients and communities we serve. We are driven to achieve the quadruple aim in health care: high quality outcomes and a better experience for patients and providers, all at a lower total cost of care. As a national leader in surgical care, SCAs 11,000 teammates operate more than 260 surgical facilities that serve over 1 million patients per year. For more information on SCA, visit www.scasurgery.com .Why join SCA? Consider the following fantastic benefits+ Positive work culture+ Career growth opportunities+ Comprehensive medical, vision and dental insurance eligible on Day 1 of employment+ Paid time off plus 8 paid holidays+ Maternity/paternity/adoption benefits+ Employer-paid life and short- and long-term disability insurance+ Excellent 401(k) Plan**Accountabilities / Responsibilities**Insurance Verification:+ 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 theappropriate 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.+ When the patients insurance is Out of Network notify the manager immediately. Follow the Policies and Procedures when accepting Out of Network payers.+ SCAs goal for each patients insurance verification is complete and accurate. 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 each patient as part of center compliance with CMS Conditions for Coverage guidelines in contacting patients prior to the date of service to review, Physician Ownership, Advance Directives and Patient Rights.Authorization:+ Obtain authorizations from insurance companies/physician offices. Ensure complete and accurate information is entered into the patient accounting system and the procedure scheduled, date of service and facility name are on the authorization. Ensure the authorization has not expired.+ Enter authorization into patient accounting system. Include the name/CPT codes effective date of theauthorized procedures.+ Ensure high cost implant/supply or equipment rental is included on authorization.+ Check insurance company approved procedure lists/medical policies. If procedure is not payable, notify patient. If patient wants to proceed, obtain signature on MedicareABN or other non-covered notification form.Financial Orientation:+ Calculate co-pay, and estimated co-insurance due from patients per the individual payer contractper the individual payer contract and plan as applicable.+ Acceptance of in-network benefits for out-of-network payers must be pre-approved bySCA Compliance Dept.+ Be familiar with individual payer guidelines and the process of collecting over the counterpayments/deductibles/copay/co-insurance. Knowledge of payer contracts including Medicare,Medicaid and other government contracts and guidelines and workmens compensation fee schedule.+ Contact the patient and communicate the center financial policy**Qualifications**+ Bachelors degree preferred but not required+ Experience checking authorizations+ Must be experienced withcptcodes+ Detailed and able to work in a high production environment+ Healthcare experience a must+ Local or within driving distancemyscabenefits.comSCA requires all new hires and employees to report their COVID-19 vaccination status. SCA will also adhere to all federal, state and local regulations as well as related company policy. When required, SCA will obtain necessary proof of vaccination prior to employment to ensure compliance.As a representative of Surgical Care Affiliates, all comments, attitudes, actions, and behaviors have a direct impact on the Facilitys success. Interaction with patients, families, physicians, referral sources, affiliated schools, visitors, volunteers, co-workers, supervisors, vendors, etc. must be in a manner that is friendly, supportive, courteous, respectful, cooperative, and professional. This behavior should promote an atmosphere of teamwork, a culture of safety, and in accordance with SCA Core Values.EEO StatementWe value Diversity, Inclusion, and Belonging at Surgical Care Affiliates: SCA is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, national origin, disability and genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.**Job Locations** _US-FL-Boca Raton_**# of Openings** _1_**Category** _Registered Nurse_**System ID** _21559_**Telecommute** _No_**Employee Type** _Regular_**Employee Status** _Full-time_**Group Name** _Legacy_

Keywords: Surgery Care Affiliates, Boca Raton , Insurance Verification Representative (FT) - Boca Raton Outpatient Surgery & Laser Center, Other , Boca Raton, Florida