Central Insurance Verification Representative - Ambulatory Support

Orlando Health

  • Orlando, FL
  • Permanent
  • Full-time
  • 22 hours ago
Position Summary:About Orlando Health:At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our dedicated team members serve communities that span Florida’s east to west coasts, Central Alabama and Puerto Rico.Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible so that you can be present for your passions. “Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you.Position Summary:Work as part of a Team which is responsible for Insurance verification for the physician, hospital, or surgery appointments. Responsibilities:Essential Functions:
  • Verify insurance plan and network to make sure that the physician office, hospital, or ambulatory surgery center is participating.
  • Contacts appropriate payers to verify insurance coverage and benefits.
  • Knowledge in the use of understanding electronic verification tools and web based resources.
  • Knowledge and familiar with a commercial and state funded insurance plans.
  • Must be able to identify an HMO, POS, Open access and/or PPO type plan.
  • Verify effective date, group number and claim address.
  • Verify copays, deductible amounts, out of pocket amounts and co-insurance.
  • Efficiently and accurately input the insurance information on the account for correct billing and proper referral processing.
  • Reviews insurance coverage for same day appointments. Reviews and worksreports for future appointments.
  • Rotate with other staff to work reports and immediate attention forms.
  • Link patient /guarantor party to the insurance on accounts.
  • Communicate with the physician offices to report eligibility issues or obtain updated information to complete verification process.
  • Identify and understand coordination of benefits when needed.
  • Create alert notes on accounts with information that the offices will need to know.
  • When insurance has an assigned PCP listed, note this on the accounts.
  • Responsible to make insurance changes to all accounts when applicable.
  • Notify Account Receivable to review accounts in question when making insurance changes.
  • Must be able to keep up with the daily productivity goal for the department.
  • Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal,
state and local standards.
  • Maintains compliance with all Orlando Health policies and procedures.
Other Related Functions:
  • Work additional reports to research missing insurance on services that were rendered.
  • Assist other team members if needed.
  • Work on assigned projects.
  • Attends and participates in department staff meetings as assigned. Qualifications:
Education/Training:
High school diploma or equivalent.Licensure/Certification:
None.Experience:
None.

Orlando Health