Visit Eligibility Validation Coordinator

JOB SUMMARY

The visit eligibility validation coordinator position exists to improve patient experience and revenue cycle performance by verifying coverage and benefits prior to ambulatory clinic visits.

The VEVC team is a highly productive, metric-driven team, that provides support to clinical operations through previsit insurance work and live phone support.

Responsibilities

JOB RESPONSIBILITIES

• Verify patient insurance eligibility 7 days prior to appointment.
• Identify appropriate guarantor for each visit.
• Identify appropriate subscriber information for all coverages associated with the visit.
• Accurately determine filing order.
• Verify visit benefits and accurately calculate patient responsibility for visit including copays, deductible, coins, and self-pay deposits.
• Obtain any authorization / referral information required for visit from payer.
• Complete all necessary registration items with patient prior to visit.
• Answer all incoming calls with exceptional customer service with a focus on compassionate patient centered care.
• Document appropriately in accordance with department expectations.
• Meets or exceeds productivity standards in the completion of daily assignments and accurate production.
• Build and maintain awareness of payer coverage rules and guidelines as well as payer portal access and user knowledge.

Qualifications

MINIMUM EDUCATION & EXPERIENCE

Education :

High School Diploma or Equivalent required (required)

Experience :

1 year of previous insurance verification experience (preferred)

Knowledge, Skills, and Abilities critical to this role :

1. Competent in use of Outlook office suite, including Outlook, Word, and Teams.

2. Multitasking, able to manage multiple cases and communication with multiple parties regarding various work topics throughout the day.

3. Service-mindset, willingly support clinics and facilities in the care of patients it a high level of customer service and professionalism.

4. Team-mindset, willingly support coworkers in various specialties.

5. Problem-solving, ability to apply knowledge in unfamiliar situations.

6. Medical terminology, ability to review clinical documentation and extract pertinent information for insurance authorization purposes.

7. Self-motivation, intrinsically driven towards excellence in quality, learning, and productivity.

Language Ability :

Must be able to communicate effectively in both verbal and written formats.

Reasoning Ability :

Able to critically think through complex patient situations, process improvements, evidence-based practice.

Computer Skills :

• Required : Able to learn and maintain access to multiple websites and applications required for daily work
• Preferred : Familiar with Epic EHR

Additional Responsibilities :

• Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times.
• Maintains confidentiality and protects sensitive data at all times.
• Adheres to organizational and department specific safety standards and guidelines.
• Works collaboratively and supports efforts of team members.
• Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff, and the broader health care community.

Additional Responsibilities :

• Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor.
• Maintains confidentiality and protects sensitive data.
• Adheres to organizational and department specific safety standards and guidelines.
• Works collaboratively and supports efforts of team members.
• Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community.
30+ days ago