Position Title: Insurance Advisor
Department: Memory Clinic
Purpose: Under the general direction of the Manager, serves as an assistant to the physicians and other support staff members. Provides support services and coordination of clerical functions to the department, including secretarial, clerical and reception tasks. Responsible for obtaining and documenting pre-certification of pre-authorized insurance requests for services and procedures. Responsible for obtaining authorizations, when required, for referrals for other services. Will interface between physicians, Genesis Medical Center departments, and insurance organizations regarding pre-certification issues. Initiate and follow up on appeals for denied payments. Will ensure that all activities achieve high patient and customer satisfaction and that pre-certification process meets physician, patient, and Genesis Medical Center needs. Serves as primary contact for clinical physicians, physician's billing office, and Genesis Medical Center support departments.
Report To: Manager, Clinic
Supervisory Responsibility: No Supervision: The job does not require the provision of guidance or supervision to others. There is no formal responsibility for directing others.
Materials Responsibility: Moderate: Work requires moderate responsibility for material resources. Examples of resources could include operating budgets for a work unit or department, specialized equipment, costly or unusual materials or supplies, large amounts of cash or other material assets. The employee has a moderate amount of control over these resources. The cost of errors might result in moderate damage, waste or financial loss. The difficulty, variety and depth of problems associated with these material resources is moderately complex.
Key Relationship: Co-workers/Health System Employees, Outside Agencies/Other Health Care Providers, General Public/Visitors/Volunteers, Physicians/Medical Office Staff, Students/Interns/Residents/Outside Instructors, Third Party Payors/Insurance Companies, Attorneys.
POSITION SPECIFICATION
Education: 2 year college program or equivalent experience
Field Of Study: Finance, Business, or related field
Special Training: Word processing and other Windows-based computer applications, experience in billing, insurance verification, customer service & front desk registration.
Training Preferred: Medical Terminology, ICD-CM Coding, training/experience, experience in billing, accounts receivable, insurance and pre-authorization verification.
Experience: More than 1 year experience required.
Interpersonal Skills: Interaction is with a variety of people. These may be fellow employees, customers, the public or others outside the organization. Communications are of limited difficulty. Interactions usually involve short, straightforward exchanges of information. The job requires a limited amount of interpersonal skills. Interactions are non-stressful encounters and dealing with uncomplicated problem situations.
Working Conditions: There is limited exposure to moderately adverse and undesirable environmental conditions. There are some health and safety risks. Position may require safety equipment and precautions. The amount of time the employee may experience these moderate conditions is limited to 10% or less of their work day.
Possible Exposure to Blood Borne Pathogens: Yes
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.