Insurance Verification & Eligibility

• Verify insurance coverage, eligibility, and benefits prior to service.
• Obtain and document authorization and referral requirements.
• Identify coverage limitations and communicate financial responsibility to patients.
• Research and resolve insurance eligibility discrepancies.

Point-of-Service Collections

• Collect patient financial responsibility in accordance with organizational policies.
• Utilize approved collection scripting and customer service techniques.
• Process patient payments accurately and maintain required documentation.
• Establish payment arrangements consistent with hospital guidelines.

Patient Access Functions

• Review registrations for accuracy and completeness.
• Assist with registration activities as needed.
• Ensure required patient forms and consents are completed.
• Maintain confidentiality of patient information in accordance with HIPAA regulations.

Customer Service

• Deliver professional, compassionate service to patients, families, physicians, and staff.
• Address patient concerns regarding financial matters promptly and professionally.
• Maintain a positive patient experience while discussing sensitive financial information.

Compliance & Quality

• Follow all hospital, state, federal, and regulatory requirements.
• Maintain compliance with HIPAA and patient privacy standards.
• Participate in departmental quality improvement initiatives.
• Complete required annual education and competencies.

• Knowledge, Skills, and Abilities

  • Understanding of insurance verification and eligibility processes.
  • Knowledge of financial assistance programs and patient payment options.
  • Strong communication and customer service skills.
  • Ability to handle sensitive financial discussions with professionalism and empathy.
  • Strong analytical and problem-solving skills.
  • Proficiency with electronic medical record systems and Microsoft Office applications.
  • Ability to maintain confidentiality and comply with HIPAA requirements.

  Performance Expectations

  • Maintain accurate insurance verification and financial counseling documentation.
  • Meet established point-of-service collection goals.
  • Achieve departmental quality and productivity standards.
  • Demonstrate professionalism, teamwork, and excellent customer service.
  • Support organizational goals related to patient satisfaction, revenue integrity, and compliance