Insurance Verification Representative I - Appalachian Regional Healthcare System

The Insurance Verification Representative is responsible for verifying patient insurance coverage to ensure necessary procedures are covered by an individual's provider. This role involves contacting insurance companies to confirm benefit information and accurately entering data into the patient information system. The ideal candidate will have strong attention to detail, excellent communication skills, and the ability to manage multiple tasks efficiently. Key Responsibilities:

Insurance Verification:

• Verify insurance coverage and eligibility for patients scheduled for services.
• Contact insurance companies to obtain pre-certification, authorization, and referral requirements for procedures.
• Confirm benefits, co-pays, and coverage details.
• Communicate with patients regarding their insurance coverage and any potential out-of-pocket costs.

Data Entry and Documentation:

• Accurately enter insurance information into the patient management system.
• Document all insurance verification and authorization activities.
• Maintain up-to-date records and ensure all information is accurate and complete.

Communication and Coordination:

• Collaborate with healthcare providers, billing departments, and patients to resolve insurance-related issues.
• Respond to inquiries from patients and staff regarding insurance coverage.
• Escalate complex cases to the Insurance Verification Supervisor or Manager as needed.

Compliance and Confidentiality:

• Adhere to all applicable regulations and guidelines related to patient privacy and data protection (e.g., HIPAA).
• Maintain strict confidentiality of patient information.

Compensation is competitive and commensurate with education and experience. Hiring compensation ranges from $15.75 - $22.83 / hour. This position is benefits eligible after a 60-day waiting period.

Position Qualifications

• Minimum Education
  • High School Diploma / GED is required.
• Experience
  • Three to six months of experience in a medical office, clinic, or acute care site is preferred, but not required.
• Required Registration/License/Certification
  • N/A
• Knowledge, Skills and Abilities
  • Knowledge of and works within the scope of the admissions and scheduling representative.
  • Ability to communicate courteously and effectively with the public, patients, family, staff, and physicians; acts within the chain of command, utilizing positive verbal and non-verbal skills.
  • A clear understanding of computer processes, fax, phone, and scanning.
  • Knowledge of compliance and attention to detail.
  • Ability to demonstrate exceptional customer service to patients, family, staff, and physicians.
• Physical Demands
  • Lifts, pushes, and pulls, up to 50 pounds
  • Manual dexterity and mobility
  • Prolonged, extensive or considerable sitting/standing/walking > 7 hours per day
  • Bending, squatting, twisting, turning
  • Near acuity: ability to see clearly at 20 inches or less
• Working Conditions
  • Regularly exposed to the risk of bloodborne diseases
  • Exposed to hazards from electrical/mechanical/power equipment
  • Exposed to odorous chemicals and specimens
  • Exposed to unpleasant elements (accident, injury, slippery surfaces uneven surfaces), etc.
  • Handles emergency or crises
  • Subject to irregular hours (days, evenings, nights, weekends, holidays)

About UNC Health Appalachian

UNC Health Appalachian, the leader for healthcare in the High Country, comprises three hospitals, 13 medical practices, Seby B. Jones Regional Cancer Center, The Rehabilitation Center, and Appalachian Regional Healthcare Foundation. UNC Health Appalachian stays committed to promoting health in the High Country, enhancing quality of life, and simply “making life better.“

About UNC Health

UNC Health is a state entity and an affiliated enterprise of the University of North Carolina system, comprised of 14 hospitals, 18 hospital campuses and more than 500 clinics along with the clinical patient care programs of the UNC School of Medicine (SOM). It exists to improve the health and well-being of North Carolinians and others we serve and to further the teaching mission of the University of North Carolina SOM. Over the past three years, UNC Health has provided more than $400 million in uncompensated or charity care to the citizens of North Carolina. Our hospitals have received numerous awards and recognition for quality care, patient safety and the overall patient experience. For more information, please visit unchealth.org.

UNC Health Appalachian embraces diversity and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other protected status. We value a workforce that reflects a variety of backgrounds and perspectives, as it enhances our ability to provide outstanding care. We welcome and encourage applications from candidates of all backgrounds and experiences. UNC Health Appalachian is committed to providing a fair and inclusive hiring process and a workplace where all team members feel respected and empowered. If you require accommodations during the application process, please contact us.

Employment at UNC Health Appalachian is contingent upon successful completion of a background and drug screen.

For accommodations or additional information, contact recruitment@apprhs.org.

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