Patient Benefits Coordinator

About Regent Surgical Health

Since 2001, Regent Surgical Health has been a leader in developing and managing successful surgery center partnerships between hospitals and physicians. We continually improve and evolve the ASC model based on changing market conditions to stay ahead of emerging trends. From this vantage point, our team has developed proprietary ASC ownership models that give both physicians and hospitals what they need to ensure long-term clinical and financial success.

Regent offers a comprehensive and competitive benefits package as one way to recognize our employee's contribution to the success of the organization and our role in helping you and your family to be healthy, feel secure and maintain a work/life balance.

Pursuant to the ADA, Regent will provide reasonable accommodation(s) to all qualified employees with known disabilities, where their disability affects the performance of their essential job functions, except where doing so would be unduly disruptive or would result in undue hardship.

We do not discriminate in practices or employment opportunities on the basis of an individual's race, color, national or ethnic origin, religion, age, sex, gender, sexual orientation, marital status, veteran status, disability, or any other prohibited category set forth in federal or state regulations.

We are an equal opportunity employer.

POSITION SUMMARY:

Under the direction of the Business Office Manager, the Insurance Verification Specialist ensures patients have valid and adequate insurance coverage for surgical services. They verify patient information, insurance eligibility and benefits, and authorizations and referrals before treatment including communication regarding financial responsibilities. This role requires strong communication with patients and physicians’ offices, attention to detail, and knowledge of healthcare insurance plans and billing procedures.

DUTIES/RESPONSIBILITIES:

• Verify insurance coverage by confirming patient’s insurance eligibility and benefits with various providers (HMOs, PPOs, Medicare, and Medicaid); document and update patient insurance details in the system and maintain up-to-date records.
• Investigate and resolve discrepancies in insurance information attached to patient account.
• Ensure valid authorizations were received from physician’s office for the scheduled procedure; confirm by contacting insurance companies and contacting physician’s offices in the event of missing authorizations.
• Communicate coverage details, and financial estimates to patients prior to services rendered; obtain payments for procedures; address insurance-related inquiries.
• Collect any outstanding balances; inform revenue cycle when account has outstanding insurance balance.
• Document all necessary information to the billing department for accurate claims processing.
• Adhere to HIPAA and other relevant regulations.
• Understand and apply ICD-10, CPT, and HCPCS codes when verifying coverage.
• Remain current on all case verification; standard operating procedure is two weeks prior to date of service.
• Notify the Business Office Manager in the event of insurance or authorization discrepancies or balances due.
• Run daily reports to ensure all cases are verified, authorized, and financial counseling is complete.
• Perform other duties as assigned.

EDUCATION/EXPERIENCE

REQUIRED:

• High school diploma or equivalent
• Insurance verification or billing experience in a healthcare environment
• BLS certification (as required by individual ASC policy)

PREFERRED

• Two years of insurance verification or billing experience in a healthcare environment