Insurance and Referral Specialist
To see if this position qualifies for a sign-on bonus, click here: Valley Health Sign-On Bonuses
Please Note: To protect our patients, our workforce and our community, Valley Health is requiring that all newly hired employees and internal transfers (current employees requesting internal transfers) must have received at least one COVID-19 vaccination dose. Newly hired Applicants (those not currently employed by Valley Health) who have been offered a position will have to provide documentation of their vaccination status at the time of their Employee Health appointment. For internal transfers, Employee Health will contact you if they have questions around your vaccination status. Valley Health has a process for applicants who have been offered a position to request an exemption or deferral for medical or religious reasons. To search for vaccine locations, visit vaccines.gov.
Description
- Entity: Valley Health Medical Group (VHMG)
- Shift: Day
Who We Are
Valley Health System is a not-for-profit network of hospitals, urgent cares, physician practices, and services. Expanding across Virginia, West Virginia, and Maryland, we are devoted to the health of all who call our 18-county area home.
A vital resource for healthcare, we are the region’s largest employer, a dependable community partner, and are at the leading edge of clinical innovations.
We are looking for passionate, innovative, and caring people who will each bring their unique skills and perspectives to our workplace.
What You Will Do:
The Insurance and Referral Specialist coordinates the front end of the revenue cycle by processing pre-registration, registration, demographic and financial verification activities. The specialist analyzes insurance payor/plans and verifies eligibility through Epic’s RTE platform or third party websites, documents responses of eligibility accurately in the patient’s medical record. Coordinates with verification of insurance benefits for all patients within 48 hours of seminar attendance, calls patients within 72 hours of the seminar to communicate results of benefits verification and to schedule an initial consultation appointment. The specialist counsels patients with exclusions on self-pay and financing options and meet with each patient at the end of initial consultation appointment to discuss insurance and clinical requirements and the process to surgery. The Insurance and Referral Specialist is responsible for tracking patient status and entering all insurance and appropriate data in tracking tool. They collaborate with the bariatric patient navigators and other team members to ensure there is clear communication on insurance requirements, referring reason, patient preferences, etc. The Insurance and Referral specialist tracks referrals, responds to referring providers, contacts referred patients to initiate care and ensures referrals are completed properly.
What You Will Bring:
Education
High School Diploma or GED required*
* Five years medical clinic experience in lieu of degree
Experience
Five years customer service related experience required
Experience working in a medical clinic setting required
Three years working with insurance companies and obtaining authorizations preferred
Experience with ICD and CPT coding required
Qualifications
Strong computer skills required
Ability to demonstrate excellent judgment required
Excellent verbal and written communication skills required
Ability to accurately document patient status required
Ability to manage multi tasks/assignments simultaneously required
Ability to function as team member and promote teamwork required
Knowledge of EMR system preferred
What You Will Get:
At Valley Health, we believe everyone is a caregiver, and our goal is to create an environment where our caregivers thrive physically, financially, and emotionally. In addition to a competitive salary, our most popular benefits for full-time employees include:
• A Zero-Deductible Health Plan
• Dental and vision insurance
• Generous Paid Time Off
• Tuition Assistance
• Retirement Savings Match
• A Robust Employee Assistance Program to help with many aspects of emotional wellbeing
• Membership to Healthy U: An Incentive-Based Wellness Program
Valley Health also offers a health savings account & flexible spending account for childcare, life insurance, short-term and long-term disability, and professional development. In addition, several perks come with working for the largest employer in the region, such as discounts to on-campus dining, and more.
To see the full scale of what we offer, visit valleyhealthbenefits.com.
Exclusions apply
We celebrate, support, and thrive on our differences for the benefit of our employees, our patients, and the communities we serve.
We are neighbors caring for neighbors, and our goal is always to help those we serve get well, feel well, and stay well.
EOE
Criminal Background Checks
VA State Police
3rd party Background Check
FLSA Classification
Non-exempt
Grade
107
Physical Demands
6 A Customer Service