Gastroenterology and Associates in Olympia is seeking a Part Time (non-benefited) Insurance Verification Specialist!

JOB SUMMARY
Verifies insurance coverage based on information provided by physician offices at the time of
scheduling. Contacts patient to gather additional information, if needed, as well as to notify them of
their financial responsibility prior to the scheduled date of service.
Reviews financial obligation with patient and authorized party following USPI’s Surgicares program or
any other program established by the company. Pre-qualifies third party coverage of scheduled
procedure(s). Actively coordinates with materials management regarding required implants, equipment
and/or supplies needed for scheduled cases in order to calculate allowable and patient responsibility
accurately.
Follows all policies and procedures.
THESE DUTIES ARE IN ADDITION TO ANY OTHER DUTIES ASSIGNED TO THE INDIVIDUAL BY
MANAGEMENT.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES: Includes the following. Other duties may be
assigned by management.
Communication Responsibilities to include, but not limited to:
 Provides payment arrangement documentation for surgical procedures to appropriate
individuals
 Maintains current materials, such as Care Credit brochures and forms, MedDraft forms, etc. for
patient education, review and signature.
 Discusses documentation with patient and family member confirming instructions are
understood and questions answered
 Answers patient and authorized party’s questions and refers questions to healthcare
professionals when appropriate
 Communicates pertinent information from physician, support staff, insurance companies and
other significant parties to the patient
 Reviews pre-qualification for third party payer before date of scheduled admission and contacts
payer to ensure facility is covered for pre-certifications and pre-qualifications.
 Verify Insurance Benefits and Determine patient responsibility based on Insurance Contract
 Verifies insurance payments and billing packets for central billing office
Counsels patients about facility charges, insurance coverage, and patient responsibility.
 Discusses financial obligations with the patient or authorized party, explaining fees and
reimbursement process
 At patient request, provides a written explanation of estimated fee schedules prior to surgery
and documents it in the patient’s medical record
 Determines patient qualification for coverage by third party payer and informs patient or
authorized party of status. If patient is not covered, arranges for payment following company
designated program
 Assists in planning a payment schedule for the patient, if appropriate
 Completes data entry of patient cost sheets, insurance verification forms, payment arrangement
forms completely and accurately and assures any forms needing patient review and signature
are provided to registration prior to the date of service
 Obtains demographic information / surgical checklists from scheduling
 Places calls to offices as needed to obtain and to ensure timely processing of verification
 Performs insurance verification process and completes it with thorough documentation of
benefits, patient information and any other financial information obtained.
 Enters complete and accurate information into computer system, such as on verification button,
in comments, in registration module, etc., so that mistakes are avoided, claims are clean and all
information is available to all appropriate personnel
 Verifies that procedures scheduled are procedures covered when performed in an ASC by the
payer by checking Medicare and Medicaid fee schedules.
 Uses all calculators available such as Medicare, workers compensation, out of network, etc.,
accurately
 Calculates allowable as directed by management for all cases.
 Notifies management for approval when an out of network case, charity case, courtesy case,
financial hardship case, or self-pay case is received prior to contacting patient.
 Cross cover for patient check in at the front desk for vacations and sick calls when needed.
Reports daily to management about current status of projects or workflow
Performs all other duties as assigned by management
KNOWLEDGE SKILLS AND OTHER REQUIREMENTS:
 Ability to handle confidential information
 Ability to set priorities and to work independently
 Ability to interact in a positive manner with co-workers, supervisor and other facility employees
 Ability to handle multiple tasks
 Ability to enter data into computer, file large amounts of paper and use office equipment
 Knowledge of how to access benefits from various sources such as phone, person, websites
 Ability to interpret benefits in order to convey to patient and to calculate allowable
 Ability to use discretion in dealing with the public
 Strong interpersonal skills
 Ability to communicate patient benefits and payment options effectively and professionally
 Ability to calculate allowable and patient responsibility accurately
 Knowledge of medical terminology
The above statements are intended to describe the general nature and level of work being performed by
individuals assigned to their job. They are not intended to be an exhaustible list of all responsibilities,
duties, knowledge, skills and abilities required of individuals so classified.
TOTAL EDUCATION, VOCATIONAL TRAINING AND EXPERIENCE
High school diploma or equivalent. Previous experience in healthcare facility business office is desired.
Computer, office equipment skills are required. Medical terminology required.

Benefits

USPI offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave)
• 401k retirement plan
• Paid holidays
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.

Salary: $20.80-$26.65 per hour