Newport News, Virginia
Responsible for verifying insurance eligibility and benefits, obtaining authorizations and providing patient estimates. Researches, follows-up and resolves open and pending authorizations in a timely manner. Monitors work queues, managing workload and completing accounts effectively.
What you will do
Obtains, validates and updates insurance information in the database, verifying eligibility and benefits. Utilizes effective and professional communication with patients, physicians' offices, and staff.
Calculates and provides patient estimates and financial obligations. Ensures collection and/or notification of payment due for services to be rendered. Provides information and resources for patients regarding RHS financial assistance and self-pay processes.
Verifies and/or obtains the necessary referral, authorization, or pre-certification prior to services being provided as required by payer.
Researches and obtains missing information from provider practices, providing timely notification of issues, denials, and/or need for peer to peer.
Monitors work queues, managing workload and completing accounts in a timely manner; follows current department workflows, staying up to date on changes.
Utilizes Riverside Care Difference principles in all interactions and maintains strict confidentiality in all matters relating to PHI.
Identifies issues and trends related to pending/denied authorizations, escalating to team lead and/or manager.
Participates in continuing education and other learning experiences, sharing gained knowledge with team.
Navigates online portals and systems to determine authorization requirements; catalogs and tracks authorization requests.
Qualifications
Education
High School Diploma or GED, (Required)
Experience
1 year Revenue Cycle experience (Required)
Licenses and Certifications
Certified Healthcare Access Associate (CHAA) - National Association of Healthcare Access Management (NAHAM) (Preferred)
To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers
Riverside Health is a non-profit, integrated network of hospitals, physicians, continuing care facilities, wellness centers, etc. providing comprehensive, high quality health care services to citizens of eastern Virginia. Riverside has been the leading provider of state-of-the-art healthcare in the region since 1915.
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