1. Title: Precert/Insurance Verification
2. Job Code: 8976
3. Job Stream Description: Support/Technical
4. Title: Precert/Insurance Verification
5. Job Code: 8976
6. Job Stream Description: Support/Technical

• 1.Verify insurance eligibility for new and returning patients, utilize Passport, telephone, internet tools as necessary to obtain verification of insurance coverage2.Correct/update all coverage information in practice management system as necessary3.Obtain all pre-certs and authorizations necessary to ensure collectivity of services performed4.Work directly with clinic and central scheduling to assist and/or perform insurance verification, precerts, etc. for all walk in or STAT patients as responsible during business hours; train clinic staff to perform this function after hours5.Answer patient/clinic calls in a professional manner on an as needed basis6.Perform or assist with referring office in-services related to insurance/precert issues on an as needed basis7.Organize and prioritize work appropriately8.Take initiative in identifying/researching insurance payor issues, educate appropriate staff as necessary9.Maintain confidentiality10.Other duties as assigned

TECHNICAL CAPABILITIES:

CORE CAPABILITIES:

SUPPORTING COLLEAGUES (S2):

• - Develops Self and Others: Continuously improves own skills by identifying development opportunities.
• - Builds and Maintains Relationships: Seeks to understand colleagues priorities, working styles and develops relationships across areas.
• - Communicates Effectively: Openly shares information with others and communicates in a clear and courteous manner.

DELIVERING EXCELLENT SERVICES (S2):

• - Serves Others with Compassion: Invests time to understand the problems, needs of others and how to provide excellent service.
• - Solves Complex Problems: Seeks to understand issues, solves routine problems, and raises proper concerns tosupervisors in a timely manner.
• - Offers Meaningful Advice and Support: Listens carefully to understand the issues and provides accurate information and support.

ENSURING HIGH QUALITY (S2):

• - Performs Excellent Work: Checks work quality before delivery and asks relevant questions to meet quality standards.
• - Ensures Continuous Improvement: Shows eagerness to learn new knowledge, technologies, tools or systems and displays willingness to go above and beyond.
• - Fulfills Safety and Regulatory Requirements: Demonstrates basic knowledge of conditions that affect safety and reports unsafe conditions to the appropriate person or department.

MANAGING RESOURCES EFFECTIVELY (S2):

• - Demonstrates Accountability: Takes responsibility for completing assigned activities and thinks beyond standard approaches to provide high-quality work/service.
• - Stewards Organizational Resources: Displays understanding of how personal actions will impact departmental resources.
• - Makes Data Driven Decisions: Uses accurate information and good decision making to consistently achieve results on time and without error.

FOSTERING INNOVATION (S2):

• - Generates New Ideas: Willingly proposes/accepts ideas or initiatives that will impact day-to-day operations by offering suggestions to enhance them.
• - Applies Technology: Absorbs new technology quickly; understands when to utilize the appropriate tools and procedures to ensure proper course of action.
• - Adapts to Change: Embraces change by keeping an open mind to changing plans and incorporates change instructions into own area of work.

Additional Qualification Information:


• Willingness to work evenings and/or weekends as needed. Willingness to attend continuing education courses at the request of the employer.


Physical Requirements/Strengths needed & Physical Demands:


• Light Work category requiring exertion up to 20 lbs. of force occasionally and uses negligible amounts of force to move objects.


Movement


• Occasional: Sitting: Remaining in seated position
• Occasional: Standing: Remaining on one's feet without moving.
• Occasional: Walking: Moving about on foot.
• Occasional: Lifting under 35 lbs: Raising and lowering objects under 35 lbs from one level to another
• Occasional: Carrying under 35 lbs: Transporting an object holding in hands, arms or shoulders, with help of coworkers or assistive device.
• Occasional: Push/Pull: Exerting force to move objects away from or toward.
• Occasional: Bending/Stooping: Trunk bending downward and forward by bending spine at waist requiring full use of lower extremities and back muscles
• Occasional: Balancing: Maintaining body equilibrium to prevent falling when walking, standing, crouching or maneuvering self, patient and equipment simultaneously while working in large and small spaces
• Occasional: Climbing: Ascending or descending stairs/ramps using feet and legs and/or hands and arms.
• Occasional: Crawling:Moving about on hands and knees or hands and feet.
• Occasional: Kneeling:Bending legs at knees to come to rest on knee or knees.
• Occasional: Crouching/Squatting: Bending body downward and forward by bending legs and spine.Reaching above shoulders: Extending arms in any direction above shoulders.
• Occasional: Reaching below shoulders: Extending arms in any direction below shoulders.
• Occasional: Handling: Seizing, holding, grasping, turning or otherwise working with hand or hands.
• Occasional: Fingering: Picking, pinching, gripping, working primarily with fingers requiring fine manipulation.
• Occasional: Bimanual Dexterity: Requiring the use of both hands.


Sensory


• Occasional: Communication: Expressing or exchanging written/verbal/electronic information.
• Occasional: Auditory: Perceiving the variances of sounds, tones and pitches and able to focus on single source of auditory information
• Occasional: Vision: Clarity of near vision at 20 inches or less and far vision at 20 feet or more with depth perception, peripheral vision, color vision.
• Occasional: Smell: Ability to detect and identify odors.
• Occasional: Feeling: Ability to perceive size, shape, temperature, texture by touch with fingertips.
• Occasional: Taste: Ability to detect quality, texture, consistency and taste of prepared foods/quality control.


Environmental Conditions