Insurance Coordinator
DSI Renal Inc. - Nashville, TN

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DSI Renal Job Description Job Title: Insurance Coordinator Reports To: Patient Intake Director FLSA Status: Non-Exempt Shift: 12:00pm to 8:30pm SUMMARY: Perform all components of Insurance Verification for all new patients, existing patients, transient patients, and prospective patients. The Insurance Coordinator works closely with insurance companies to verify Dialysis Benefits. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
• New Patients – Verify effective date and benefit information including deductible, out of pockets, co-pays, and lifetime max. All new patients must be verified within 48 hours.
• Notification – Notify Admission Coordinator of benefits for new Patients. Notify the Financial Coordinator on all new patients and any benefit/insurance changes.
• Coordination of Benefits – Understand Coordination of Benefits (COB) rules and guidelines established by Medicare, and make appropriate changes in Pearl when necessary. Identify and update incorrect MSP files with all payers.
• Authorization – Obtain all initial authorizations as applicable. Add certification/authorization numbers into Pearl.
• Insurance Changes – Verify effective date and benefit information including deductible, out of pockets, co-pays, and lifetime max. Update information in Pearl and determine if claim rollback/repricing are necessary.
• Emails/Correspondence – Work emails efficiently and in order of importance.
• Red Flag Database – Review, document and close problems entered into the “red flag” database.
• Gather demographic, financial, social and clinical information required to complete patient verification.
• Enter all insurance information collected into Pearl in a timely manner and with a high degree of accuracy.
• Obtain patient responsibility amounts and/or methodology to determine patient responsibility amounts during third party coverage verification procedures.
• Prioritize work and completes all assigned work on a daily basis. Readily identifies patients whose insurances have not been verified. Other duties and responsibilities as assigned
• Attend educational activities, in-services, and staff meetings as required.
• Consistent, regular attendance as scheduled in compliance with attendance policies.
• Identify confidential information and maintain strict confidentiality of information
• Deal effectively with a diversity of individuals at all organizational levels.
• Ability to lift up to 25 lbs. and able to perform repetitive standing, sitting, stooping, walking, stretching, reaching and use full range of body motions including continuous keyboarding and telephone use. Hearing must be adequate to handle telephone call answering and response.
• Comply with company policies and procedures in accordance with state and federal regulations (CMS, HIPAA, OSHA or other governing agencies)
• Read, understand and follow company patient and employee policies and procedures including but not limited to HIPAA requirements SUPERVISORY RESPONSIBILITIES This position has no supervisory responsibilities. QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION AND/OR EXPERIENCE
• High School diploma or GED required. Associate Degree preferred.
• Minimum of 6 months experience in patient registration in hospital or medical setting preferred.
• Knowledge of medical terminology.
• Knowledge of various health insurance programs and knowledge in the medical insurance industry required. COMPUTER SKILLS To perform this job successfully, an individual should have intermediate knowledge of Microsoft Outlook, Word and Excel. Must be able to adapt and learn new Windows-based computer software systems. LANGUAGE and OTHER SKILLS/REASONING ABILITY
• Ability to read, analyze and interpret general health care and/or business periodicals, professional journals and governmental regulations.
• Ability to create reports and write business correspondence.
• Ability to effectively present information and respond to questions from patients, physicians, billing, insurance companies and the general public.
• Ability to define problems, collect data, establish facts and draw valid conclusions.
• Ability to deal with several abstracts and concrete variables.
• Exceptional interpersonal skills.
• Requires research and exceptional organizational skills to effectively manage a large patient load. MATHEMATICAL SKILLS
• Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals.
• Ability to compute rate, ratio and percentages. PHYSICAL DEMANDS The physical requirements can vary. In general, the position requires the following activities:
• Ability to lift up to 25 lbs. and able to perform repetitive standing, sitting, stooping, walking, stretching, reaching and use full range of body motions including continuous keyboarding and telephone use. Hearing must be adequate to handle telephone call answering and response. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION AND/OR EXPERIENCE
• High School diploma or GED required. Associate Degree preferred.
• Minimum of 6 months experience in patient registration in hospital or medical setting preferred.
• Knowledge of medical terminology.
• Knowledge of various health insurance programs and knowledge in the medical insurance industry required.
COMPUTER SKILLS
To perform this job successfully, an individual should have intermediate knowledge of Microsoft Outlook, Word and Excel. Must be able to adapt and learn new Windows-based computer software systems.
LANGUAGE and OTHER SKILLS/REASONING ABILITY
• Ability to read, analyze and interpret general health care and/or business periodicals, professional journals and governmental regulations.
• Ability to create reports and write business correspondence.
• Ability to effectively present information and respond to questions from patients, physicians, billing, insurance companies and the general public.
• Ability to define problems, collect data, establish facts and draw valid conclusions.
• Ability to deal with several abstracts and concrete variables.
• Exceptional interpersonal skills.
• Requires research and exceptional organizational skills to effectively manage a large patient load.
MATHEMATICAL SKILLS
• Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals.
• Ability to compute rate, ratio and percentages.
PHYSICAL DEMANDS
The physical requirements can vary. In general, the position requires the following activities:
• Ability to lift up to 25 lbs. and able to perform repetitive standing, sitting, stooping, walking, stretching, reaching and use full range of body motions including continuous keyboarding and telephone use. Hearing must be adequate to handle telephone call answering and response.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

DSI Renal Inc. - 18 months ago - save job - block
About this company
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DSI Renal is a leading provider of dialysis services in the United States to patients suffering from chronic kidney failure. We plan growth...