Job Summary: Provides insurance verification for all scheduled and unscheduled same day surgery patients, through contact with insurance companies, employers, patients and patients' families.
Essential Job Functions:
Begins and sets up the precertification process for the Utilization Review Coordinators to obtain authorization for the patient stay through their clinical review.
Obtains and documents benefits in the BAR system for cash collection and billing follow up.
Prints the daily census as of midnight for inpatients (Inpatient Admission Register by Time).
Prints the Inpatient Scheduling Appointment List daily.
Divides all inpatient and/or observation registration sheets by insurance; i.e. Blue Cross, Medicare, Mamsi, USHC, etc.
Reviews all self pay patients for possible coverage, ability to pay, etc. Checks the Meditech system for previous dates of service and previous insurance/payment information.
Telephones the insurance company for benefits and obtains the telephone number for precertification and calls for a Precert and verifies the patient identification number, group number and the claim address.
Resolves issues whenever there is a discrepancies in insurance.
Contacts the Utilization Review Case Coordinator responsible for the case in reference to any insurance discrepancies so that both insurances can be updated with concurrent review if necessary.
Contacts Ancillary Departments for which benefits are verified in reference to any discrepancies, precertification or authorization problems encountered in a timely manner.
Updates self pay accounts when billing information is obtained. Verifies and updates all insurance information, demographics, pre-existing conditions, etc. to insure prompt and proper payment of the claim Documents all verified information following the format established on the Insurance verification/Precertification Form.
Assists coworkers with inquiries to specific payor/patient, benefit and precertification criteria as requested.
This job requires employees to demonstrate initial and annual competencies in order to remain in the position. Performs other duties as assigned by management.
Education: High School Diploma or GED equivalent required. Some college course work preferred.
Licenses / Certifications: None Required.
Experience: Minimum six months of insurance billing and word processing or related experience preferred. Work Schedule: Full time: Monday - Friday 8:00am - 4:30pm, Attendance at special events as requested. Potential for occasional weekend or holiday assignments/projects.
Internal Number: JR57474
About ChristianaCare Health System
ChristianaCare Health System is headquartered in Wilmington, Delaware and is one of the country's largest health care providers, ranking 21st in the nation for hospital admissions. Christiana Care is proudly a Nurse Magnet recognized institution. Christiana Care Health System is also one of the largest health care providers in the mid-Atlantic region, serving all of Delaware and portions of seven counties bordering the state in Pennsylvania, Maryland and New Jersey. A not-for-profit, non-sectarian health system, Christiana Care includes two hospitals with more than 1,100 patient beds, and is a major teaching hospital with two campuses. Christiana Care is continually recognized for excellence on a regional and national level. Our role in the community is expressed in the Christiana Care Way: "We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value."Christiana Care is a great place to work because we value diversity and recognize it to be a core part of our success. Because of the diversity of our employees, affiliated health professionals and volunteers, we are ...positioned to meet the unique needs of our patients and community. We acknowledge and celebrate the uniqueness and talent of each employee. Because of our talented workforce we are able to provide a quality healthcare experience to our patients and community. We strive to create an inclusive environment in which individual diversity can be leveraged and thrive. Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.