Sr Insurance Verifier

At Houston Methodist, the Senior Insurance Verifier position is responsible for obtaining and recording eligibility and benefit information for patients receiving services and initiates the admission notification and authorization process in a timely manner. The Senior Insurance Verifier communicates to resolve patient access and quality service matters and demonstrates an ability to perform more complex processes related to insurance verification, authorization, and financial clearance.

This position will also utilize effective communication skills in all interactions with patients, co-workers, insurance companies, physicians etc. This position will be part of the infusion/oncology team, so experience in this space is highly preferred. This role is also eligible for work from home opportunity (within greater Houston area) once training has been complete.

 FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.) EXPERIENCE Three years of insurance verification experience in a healthcare setting, preferably in a hospital or clinic setting SKILLS AND ABILITIES Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles Proficiency in Microsoft office components (e.g., Outlook, Word) and knowledge of electronic health record software (EPIC preferred) Knowledge of Medicare, Medicaid, and managed care reimbursement methodologies Ability to manage multiple tasks at one time Understands medical terminology at a high level and has knowledge of insurance requirements for physician visits and procedures Ability to manage a fast-paced environment Ability to flex hours and work/day assignments to meet needs related to unanticipated patient volume Ability to review clinical documentation for Medical Necessity and payer requirements Working knowledge of CPT, International Classification of Diseases (ICD)-9 and/or ICD-10 preferred ESSENTIAL FUNCTIONS PEOPLE ESSENTIAL FUNCTIONS Promotes a positive work environment and contributes to a dynamic, team focused work unit that actively helps one another achieve optimal department results.

Supports Insurance Verifiers with questions regarding pending authorizations and eligibility/benefit information for patients receiving services. Assists other team members (e.g., registration, financial counseling) as directed by management. Seeks management assistance appropriately. Contributes to patient, employee, and physician satisfaction. Proactively presents solutions to resolve access to care issues when possible.

Serves as a liaison between the patients, facility, physicians, and department to ensure timely and accurate financial clearance of all accounts. Communicates with scheduling to inform patient of authorization as needed. Trains and mentors new team members. SERVICE ESSENTIAL FUNCTIONS Ensures accounts are financially secure by reviewing and documenting benefits, patient liabilities, authorization/pre-certification requirements, notification requirements, and other relevant information.

Assists with resolving electronic health record (EHR) work queues that support insurance verification. Generates reports and assists with department correspondence as directed. Initiates authorization for services as needed utilizing clinical information provided by the ordering physician. Monitors and tracks authorizat