Insurance Verifier – Ophthalmology – Full Time 8 Hour Days (Non-Exempt) (Union) – (Los Angeles, California, United States)

The Insurance Verifier has in depth knowledge in all the functions of Insurance Verification. He/She is responsible for verifying patient insurance coverage for treatment/procedures perform or requested. The Verifier is responsible for entering data in an accurate manner and update patient benefit information in the organization’s insurance system and verify that existing information is accurate.

Essential Duties:

  • 1. Responsible for obtaining insurance information /verification/authorization to ensure financial clearance of patient accounts. Updates both professional and or hospital registration system.
  • 2. Responsible for completing all registration and insurance fields in both professional and/or hospital registration information systems.
  • 3. Responsible for completing Medical Necessity on all Medicare accounts as required
  • 4. Responsible for calling insurance or use Internet portals to obtain and document: a. Insurance eligibility and benefits, b. Financial responsibility, c. Authorization , pre cert’s as required
  • d. Contacting Medical Groups/IPA’S as needed
  • 5. Responsible for calculating patient liability on hospital accounts
  • 6. Ensure all insurance plans are properly selected in all registration and scheduling information systems.
  • 7. Responsible for clearing assigned worklists in any of the information systems.
  • 8. Communicate with physician offices regarding proposed admissions, special procedures, outpatient referrals and same day surgeries.
  • 9. Responsible for preparing pre-registration on scheduled procedures ie. Ancillary , diagnostic, surgeries
  • 10. Contact patients and/or MD office as needed for additional information
  • 11. Utilize Fax applications as appropriate
  • 12. Perform document imaging as required
  • 13. Assist Supervisor as needed with special projects and other duties assigned

Required Qualifications:

  • High school or equivalent
  • 1 year Hospital experience or in a related field.
  • Knowledge in all the functions of Insurance Verification.
  • Knowledge of all insurance types, including government health programs and insurance medical policies.
  • Must have excellent communication skills, including the ability to speak, read and write English proficiently.
  • Must be comfortable with computers and medical terminology.
  • Demonstrate excellent customer service behavior.

Preferred Qualifications:

Required Licenses/Certifications:

  • Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)

The hourly rate range for this position is $22.00 – $37.40. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

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