Medical Records Clerk/Insurance Verifier - Post-Service Team

JOB TITLE: Medical Records Clerk/Insurance Verifier - Post-Service Team

PRIMARY RESPONSIBILITIES:

• Ensure all records are maintained in absolute integrity and in compliance with applicable regulations and requirements.
• Coordinates post-service requests to ensure all documentation is correct for any post patient service such as billing or medical records.
• Under direct supervision, assembles and maintains complete medical records according to established procedures.
• Files and retrieves patient records; prepares new files; Organizes and evaluates patient medical records.
• Reviews medical records for accuracy and completeness.
• Responsible for filing and retrieving medical records.
• Obtaining required referrals and authorizations via phone, fax, on-line, etc.
• Review reports daily for patients requiring authorizations, pre-notification, and insurance benefit verification.
• Obtaining retro-authorizations or updating existing authorizations in a timely manner.
• Data entry in a fast-paced environment with high expectation on accuracy.
• Updates the patient account with details of the insurance verification.
• Coordinating with patients regarding their insurance benefits.
• Identifies deductibles, co-pays, and self-pay accounts.
• Notifying the appropriate staff members if treatment or service is denied.
• Re-verify patients monthly for active, current insurance.
• Assist manager and other staff with account questions when presented.
• Perform other duties as assigned.
• Relies on experience and judgment to plan and accomplish goals.

REQUIREMENTS:

• High School diploma or equivalent.
• Knowledge of medical terminology.
• Knowledge of insurance contracts and utilization.
• Knowledge of CPT/ICD-10
• Knowledge of deductibles, co-pays, and co-insurance.
• Knowledge of computer systems, programs and spreadsheet applications.
• Skills in written and verbal communication and customer relations.
• Skill in solving utilization problems.

Equal Employment Opportunity & Work Force Diversity

Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc. Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization.