Insurance Verification Representative (FT) - Glenwood Surgical Center
Company: Surgical Care Affiliates
Posted on: June 6, 2021
Join Our Amazing
Team! Surgical Care Affiliates has an
exciting Insurance Verification Representative
opportunity within our Revenue Cycle Group and we’d love to hear from you! If you
are interested in becoming part of an organization that is helping
to improve healthcare, then SCA is the place for you. Your
experience in insurance verification is exactly what we are looking
SCA, a leader in the outpatient surgery
industry, strategically partners with health plans, medical groups
and health systems across the country to develop and optimize
surgical facilities. SCA operates more than 200 surgical
facilities, including ambulatory surgery centers and surgical
hospitals, in partnership with approximately 3,000 physicians. For
more information on SCA, visit www.scasurgery.com.
Our team members enjoy the following
- Competitive salary
- Quarterly bonuses
- Exceptional benefits (medical, dental, vision,
401K) that begin the first day of employment
- Positive, friendly
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 the appropriate payer is selected for Primary
the centers selected vendor for claims and eligibility and/or
individual payer websites to obtain eligibility, benefits and/or
pre-certs and authorization information.
the patient insurance information into patient accounting system
ensuring the selection is the appropriate payer and associated
the patient’s insurance is Out of Network notify the manager
immediately. Follow the Policies and Procedures when accepting Out
of Network payers.
goal for each patient’s 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
Insurance Verifier will call each patient as part of center
compliance with CMS Conditions for Coverage guidelines in
contacting patient’s prior to the date of service to review,
Physician Ownership, Advance Directives and Patient
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 the
high cost implant/supply or equipment rental is included on
- Check insurance company approved procedure
lists/medical policies. If procedure is not payable, notify
patient. If patient wants to proceed, obtain signature on
Medicare ABN or other
non-covered notification form.
- Calculate co-pay,
and estimated co-insurance due from patients per the individual
payer contract per the
individual payer contract and plan as
- Acceptance of in-network benefits for
out-of-network payers must be pre-approved by SCA Compliance Dept.
- Be familiar with
individual payer guidelines and the process of collecting over the
Knowledge of payer contracts including Medicare,
and other government contracts and guidelines and workmen’s
compensation fee schedule.
- Contact the patient and
communicate the center financial policy
- Bachelor’s degree preferred but not
- Experience checking
- Must be experienced with cpt codes
- Detailed and able to work in a high production
- Healthcare experience a
- Local or within driving
We 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
Keywords: Surgical Care Affiliates, Riverside , Insurance Verification Representative (FT) - Glenwood Surgical Center, Other , Riverside, California
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