Insurance Clerk (FT) - Inland Surgery Center

Surgical Care Affiliates Redlands, CA

About the Job

Surgical Care Affiliates (SCA) is transforming specialty care in our communities. We relentlessly create value by aligning physicians, health plans and health systems around a common goal: delivering exceptional care and healing to our patients and communities we serve. We are driven to achieve the quadruple aim in health care: high quality outcomes and a better experience for patients and providers, all at a lower total cost of care. As a national leader in surgical care, SCA’s 10,000 teammates operate more than 250 surgical facilities that serve nearly 1 million patients per year. For more information on SCA, visit www.scasurgery.com.

 

Why join SCA? Consider the following fantastic benefits…

  • Positive work culture
  • Career growth opportunities
  • Comprehensive medical, vision and dental insurance – eligible on Day 1 of employment
  • Paid time off plus 8 paid holidays
  • Maternity/paternity/adoption benefits
  • Employer-paid life and short- and long-term disability insurance
  • Excellent 401(k) Plan

Position Description: The Insurance Verification teammate is responsible for ensuring scheduled procedures are on the patient’s insurance covered list and/or the patient meets self-pay criteria. The Insurance Verification teammate will be responsible for verifying insurance coverage, eligibility, benefits, obtaining authorizations and pre-certs as required by the individual insurance company.

 

Key Responsibilities:

  • 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.
  • 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 patients as needed to review patient responsibilities with regard to payment or payment plan.

  • All applicants must have at least 2 years’ experience preferably in an Ambulatory Surgery Center.
  • Computer skills, Excel & Word programs.
  • Ability to multitask
  • Knowledge of Health Plans and IPA’s.
  • Experience with HST and Citrix and Navinet