- Lubbock, Texas
- Covenant High Plains Surgery Center
- Network Management
- Regular
- Full-time
- 1
- USD $17.00/Hr.
- USD $21.00/Hr.
- 33737
- We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business.
- We have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care.
- We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
- We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines.
- Verify that sufficient information is available for accurate verification and eligibility. This step may require direct contact with the physician office and/or the patient.
- Determine if a secondary insurance should be added to the patient account ensuring the appropriate payer is selected for Primary insurance.
- Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain eligibility, benefits and/or pre-certs and authorization information.
- Enter the patient insurance information into patient accounting system ensuring the selection is the appropriate payer and associated financial class.
- When the patient's insurance is Out of Network notify the manager immediately. Follow the Policies and Procedures when accepting Out of Network payers.
- SCA's goal for each patient's insurance verification is complete and accurate. The insurance verifier will document the findings in the patient account and will contact the patient with either estimated co-insurance, co-pay and or deductible amounts due on or before the date of service as applicable
- The Insurance Verifier will call each patient as part of center compliance with CMS Conditions for Coverage guidelines in contacting patient's prior to the date of service to review, Physician Ownership, Advance Directives and Patient Rights.
- Obtain authorizations from insurance companies/physician offices. Ensure complete and accurate information is entered into the patient accounting system and the procedure scheduled, date of service and facility name are on the authorization. Ensure the authorization has not expired.
- Enter authorization into patient accounting system. Include the name/CPT codes effective date of the authorized procedures.
- Ensure high cost implant/supply or equipment rental is included on authorization.
- Check insurance company approved procedure lists/medical policies. If procedure is not payable, notify patient. If patient wants to proceed, obtain signature on Medicare ABN or other non-covered notification form.
- Calculate co-pay, and estimated co-insurance due from patients per the individual payer contract per the individual payer contract and plan as applicable.
- Acceptance of in-network benefits for out-of-network payers must be pre-approved by SCA Compliance Dept.
- Be familiar with individual payer guidelines and the process of collecting over the counter payments/deductibles/copay/co-insurance. Knowledge of payer contracts including Medicare, Medicaid and other government contracts and guidelines and workmen's compensation fee schedule.
- Contact the patient and communicate the center financial policy
- Bachelor's degree preferred but not required
- Experience checking authorizations
- Must be experienced with cpt codes
- Detailed and able to work in a high production environment
- Healthcare experience a must
- Local or within driving distance
-
Field Support Technician Ii
1 week ago
NET56 Deerfield, United States**Overview** · The primary function of this role is to act as Tier II technology support for the faculty, staff, and students of our client. Technician will be assigned a specified group of stakeholders to support. This role will be the direct contact to support various needs ass ...
-
Dispatcher (male/female/diverse)
3 days ago
Titan Industries Parkland, FL, United States Freelance**What we offer you**: · Work-life balance - balancing family and work through flexible working hours, home office, childcare, and individual agreements based on personal circumstances · High social benefits - accident insurance with 24-hour coverage, contribution to pension insu ...
-
Director Surgical Services
1 week ago
HCA Florida Woodmont Hospital Tamarac, United StatesThis position is incentive eligible. · **Introduction**: · Executives thrive with us HCA Healthcare is one of the nation's leading providers of healthcare services, comprising of over 180 hospitals and about 2,000 sites of care in 21 states and the United Kingdom. We are looking ...
-
Phlebotomist Iii Site Lead
3 days ago
Quest Diagnostics Delray Beach, United StatesOverview: · **Phlebotomist III Site Lead - **Delray Beach, FL - Monday-Friday 6:30AM-4:00PM (Rotational Weekends)** · Represents the face of our company to patients who come to Quest Diagnostics, both as part of their health routine or for insights into life-defining health decis ...
-
Administrative Specialist I
2 weeks ago
City of Hollywood, FL Hollywood, United States**JOB SUMMARY**: · **ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES**: · - Types letters, reports and forms; composes and types routine correspondence and statistical data; proofreads materials; takes and transcribes dictation; utilizes computer equipment to input and retrieve info ...
-
Utilities Field Technician Career Path
3 weeks ago
City of Boynton Beach Boynton Beach, United States**Purpose of Classification**: · **UTILITIES FIELD TECHNICIAN I** · The purpose of this classification is to perform a variety of entry level field services tasks within the Utilities department. Employees in this classification are eligible for noncompetitive career ladder promo ...
-
Virtual Services Representative
2 weeks ago
Gulf Credit Union Groves, United States**Summary/Objective** · The Virtual Services Representative is responsible for assisting members and potential members with their Credit Union needs via the centralized Virtual Services Center in a courteous, professional, and timely manner. · **Essential Job Duties** · Reasonabl ...
-
Patient Service Representative
1 week ago
Eye Surgery Associates Pembroke Pines, United StatesOverview: · **Eye Surgery Associates is searching for an energetic, patient focused, team oriented **Patient Service Representative** for our multi-specialty ophthalmology practice in Pembroke Pines, Florida. Great work hours, no major holidays, a robust benefits package, a team ...
-
Customer Account Representative
1 week ago
Parker Hannifin Corporation North Hollywood, United States**Position Summary** · **About Parker Aerospace** · Parker Aerospace, an operating segment of Parker Hannifin Corporation, is one of the world's leading producers of flight control, hydraulic, fuel and inerting, fluid conveyance, thermal management, and engine systems and compone ...
-
Regional Manager Front Desk
3 weeks ago
MD Now West Palm Beach, United StatesThis position is incentive eligible. · **Introduction**: · Do you have the career opportunities as a Regional Manager Front Desk you want with your current employer? We have an exciting opportunity for you to join CareNow which is part of the nation's leading provider of healthca ...
-
Payroll Associate
3 weeks ago
Company3/Method Studios Hollywood, United States**Company**:Company 3 · **Position**:Payroll Associate · **Location**:Hollywood, CA (On-Site) · - **Pay Range**:$ $30.00 USD hourly · **Position Summary**: · Company3/Method Studios (CO3/Method) is a global leader in media and entertainment services for film, video and online con ...
-
Admission Coordinator for Lgbtq Addiction Rehab
2 weeks ago
Inspire Recovery West Palm Beach, United States_Admissions Representative for LGBTQ Addiction Rehab._ · **Overview for Inside Sales Admissions Coordinator**: · The LGBTQ community is fiercely and fabulously supportive of each other. But traditional rehabs don't support them. · At Inspire Recovery, we recognize the LGBTQ peopl ...
-
Automotive Senior Technician
2 weeks ago
Bridgestone Americas Deerfield Beach, United States**Company Overview** · Bridgestone Retail Operations (BSRO) is part of Bridgestone Americas and employs over 22,000 teammates in North America. BSRO operates more than 2,200 company-owned stores, including Firestone Complete Auto Care, Tires Plus and Wheel Works locations. With ...
-
HR Coordinator
2 weeks ago
KGH Autism Services Deerfield, United StatesJob Description · Job Description · About KGH: · KGH is one of the few interdisciplinary autism therapy centers around, and we work together as a team to provide diagnostic services, speech therapy, occupational therapy, developmental, play-based ABA therapy, and mental health ...
-
Social Services Coordinator
4 days ago
Cano Health Deerfield Beach, United StatesIt's rewarding to be on a team of people that truly believe in making an impact We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.Job SummaryProvide general assistance to our patients in any service and c ...
-
Social Services Coordinator
5 days ago
Cano Health Deerfield Beach, United StatesIt's rewarding to be on a team of people that truly believe in making an impact · We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us. · Job Summary · Provide general assistance to our patients in any se ...
-
Contract/ Grant Administrator
3 weeks ago
Broward County, FL Deerfield Beach, United StatesSalary : $59, $94,270.74 AnnuallyLocation : Pompano Beach, FLJob Type: Full-TimeJob Number: Department: PW WWS Bus Ops Purch & WarehouOpening Date: 05/03/2024Veterans' Preference Notice: Under Section 295.07, Florida Statutes, certain servicemembers and veterans, and the spouses ...
-
Contract/ Grant Administrator
2 weeks ago
Broward County, FL Deerfield Beach, United StatesSalary : $59, $94,270.74 Annually · Location : Pompano Beach, FL · Job Type: Full-Time · Job Number: · Department: PW WWS Bus Ops Purch & Warehou · Opening Date: 05/03/2024 · Veterans' Preference Notice: Under Section 295.07, Florida Statutes, certain servicemembers and vet ...
-
HR Coordinator
1 week ago
KGH Autism Services Deerfield, United StatesJob Description · Job DescriptionAbout KGH: · KGH is one of the few interdisciplinary autism therapy centers around, and we work together as a team to provide diagnostic services, speech therapy, occupational therapy, developmental, play-based ABA therapy, and mental health serv ...
-
Manager Sampling Operations
6 days ago
Lundbeck Deerfield, United StatesDo you want to join a team where the mission is meaningful, the challenges are complex, and you can directly see the results of your hard work? At Lundbeck, we are tirelessly dedicated to restoring brain health, so every person can be their best. Inspired and driven by our purpos ...
Insurance Verification Representative - Deerfield, United States - SCA Health
Description
Insurance Verification Representative - Covenant High Plains Surgery Center JOB_DESCRIPTION.SHARE.HTML
CAROUSEL_PARAGRAPH
JOB_DESCRIPTION.SHARE.HTMLToday, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.
As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:
The new SCA Health represents who we are today and where we are going-and the growing career opportunities for YOU.
ResponsibilitiesInsurance Verification:
Authorization:
Financial Orientation:
PI731d14cac4b7-1832