Main Function - 

Contacts all insurance companies to verify description of patient(s) medical plan benefits. Estimates patient financial responsibilities and insurance reimbursement. Interacts with physicians, personnel, and patients regarding financial and authorization issues. Responsible for gathering and inputting patient demographic and financial information into the computer. The Insurance Verifier is also responsible for correcting information in the computer to ensure a clean claim. Demonstrates the primary goal of efficiently providing surgical services that exceed customer expectations and improve clinical and financial operations.

Duties and Responsibilities - 

Duties and
Responsibilities

1. Philosophy
a) Supports the facility's ideology, mission, goals, and objectives
b) Performs in accordance with the facility's policies and procedures
c) Follows the facility's standards for ethical business conduct
d) Conducts self as a positive role model and team member
e) Recognizes patients' rights and responsibilities and supports them in performance of job duties
f) Participates in facility committees, meetings, in-services, and activities
2. Communication
a) Communicates effectively and professionally with patients, visitors, physicians, and coworkers
b) Interacts with others in a positive, respectful, and considerate manner
c) Displays the ability to comprehend and interpret verbal orders and direction
d) Displays skill in oral and written communication techniques
3. Financial Practices
a) Uses facility resources appropriately and avoids wasteful practices
b) Reports wasteful practices
c) Analyzes work area and makes recommendations for potential cost-effective improvements
4. Compliance Program
a) Contributes to the progress and development of the organization's adopted compliance program
b) Performs according to established compliance policies and procedures
5. Performance-Improvement Program
a) Contributes to the progress and development of the organization's adopted performance-improvement program
b) Performs according to established performance-improvement policies and procedures
c) Participates in data collection activities to support the performance-improvement program
6. Safety/Risk-Management Program
a) Adheres to safety policies and procedures in performing job duties and responsibilities
b) Reports observed or suspected safety violations, hazards, and policy/procedure noncompliance to the safety officer or other designated person
7. Professional Competence
a) Participates in continuing education and other learning experiences
b) Shares knowledge gained in continuing education with staff
c) Seeks new learning experiences by accepting challenging opportunities and responsibilities
d) Welcomes suggestions and recommendations
8. Duties
a) Participates in development of Policies and Procedures within the department.
b) Perform registration procedures as written in Policy and Procedure Manual.
c) Perform high quality work.
d) Ability to troubleshoot equipment issues and notify all pertinent team members in a timely manner.
e) Adheres to Policies and Procedures as defined by Infection Control.
f) Greets and directs patients and visitors for the facility.
g) Contacts all insurance carriers per patient, to insurance proper coordination and reimbursement of benefits.
h) Enters information in computer system in an accurate manner.
i) Able to calculate patient out of pocket to set up approved payment arrangements if necessary.
j) Breaks down managed care contract reimbursements and estimates patient's financial responsibilities.
k) Capability to work with rigid deadlines while maintaining a high degree of accuracy.

l) Mathematical skills required to calculate percentages, interest and practical application of accounts payable functions.
m) Protects the financial integrity of the facility by verifying implant cost and specific insurance clinical policy bulletins for ever changing insurance processes.
n) Has complete knowledge of Insurance Verification duties and responsibilities.
o) Gathers patient information by collecting demographic information from a variety of sources: interacting with the registration areas and physicians' offices; retrieving information from systems.
p) Maintain continuity of work operations by documenting and communicating actions, irregularities, and continuing needs and communicate problems according to established procedures.
q) Demonstrates knowledge of the various computer systems used at facility.
r) Assists in answering incoming calls for a high volume phone queue.
s) Participates in Performance Improvement Plan.
t) Serves as a resource to other members of the health care team.
u) Act in accordance with the vision, mission, and business philosophy of the Center
v) Maintain patient, physician, and employee privacy and confidentiality per policy.
w) Follow the Center's professional conduct and dress code policy.
x) Communicate effectively and courteously with visitors, physicians and their office staffs, patients and employees.
y) Assists with other responsibilities of center as deemed necessary by management.

1. Accuracy
2. Attention to detail
3. Time management
4. Organization
5. Professionalism
6. Quality Focus
7. Productivity
8. Thoroughness
9. Accountability
10. Little supervision needed to accomplish tasks

Cooperative work attitude toward co-employees, management, patients, visitors, and physicians.
Ability to promote favorable facility image with physicians, patients, and general public.
Ability to make decisions and solve problems.
High school diploma or GED certification.
Great attitude.
CPR Certification.
Proficient typing/ keyboarding skills.
One year of experience in a hospital or customer service setting.

About United Surgical Partners International, Inc

United Surgical Partners International (USPI), a subsidiary of Tenet Healthcare Corporation (NYSE: THC), operates the largest ambulatory platform in the country. With more than 465+ facilities across the United States, the company serves patients in ambulatory surgery centers and surgical hospitals. For more information, please visit www.uspi.com. USPI’s mission is simple, but the gravity of it is profound. We care for every patient and their family as if they were our own. Each patient, each family, each and every time.

Connections working at United Surgical Partners International, Inc