JOB SUMMARY
At Houston Methodist, the Senior Insurance Verifier position is responsible for obtaining and recording eligibility and benefit information for patients receiving services and initiates the admission notification and authorization process in a timely manner. The Senior Insurance Verifier communicates to resolve patient access and quality service matters and demonstrates an ability to perform more complex processes related to insurance verification, authorization, and financial clearance. This position will also utilize effective communication skills in all interactions with patients, co-workers, insurance companies, physicians etc.
EDUCATION REQUIREMENTS
o High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
EXPERIENCE REQUIREMENTS
o Three years of insurance verification experience in a healthcare setting, preferably in a hospital or clinic setting
KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
o Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
o Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
o Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
o Proficiency in Microsoft office components (e.g., Outlook, Word) and knowledge of electronic health record software (EPIC preferred)
o Knowledge of Medicare, Medicaid, and managed care reimbursement methodologies
o Ability to manage multiple tasks at one time
o Understands medical terminology at a high level and has knowledge of insurance requirements for physician visits and procedures
o Ability to manage a fast-paced environment
o Ability to flex hours and work/day assignments to meet needs related to unanticipated patient volume
o Ability to review clinical documentation for Medical Necessity and payer requirements
o Working knowledge of CPT, International Classification of Diseases (ICD)-9 and/or ICD-10 preferred
SUPPLEMENTAL REQUIREMENTS
Work Attire Yes/No
Uniform No
Scrubs No
Business professional Yes
Other (dept approved) No
On-Call* No
Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Event, etc) regardless of selection above.
Travel**
May require travel within Yes
Houston Metropolitan area
May require travel outside No
of Houston Metropolitan area
**Travel specifications may vary by department.
Please note any other special considerations to this job: __________________________
Houston Methodist is one of the nation’s leading health systems and academic medical centers. Houston Methodist consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the heart of the Texas Medical Center, and seven community hospitals throughout the greater Houston area. Houston Methodist also includes an academic institute, a comprehensive residency program, a global business division, numerous physician practices and several free-standing emergency rooms and outpatient facilities. Overall, Houston Methodist employs more than 27,000 employees and is supported by a wide variety of business functions that operate at the system level to help enable clinical departments to provide high quality patient care.
