The Insurance Verification Representative ensures that patient demographics, insurance information, and insurance benefits are obtained and validated with the payer. This information is to be accurately reflected within the EMR for BHC appropriate communications with the payer, patient, and ordering provider must be professional and documented. In addition to the timely execution and review of benefit information, estimates are created in accordance with state regulations regarding transparency and no surprise billing. The Insurance Verification Representative works closely with case management/utilization review, payers, provider practices, patients, scheduling, financial counselors, and registration to ensure proper financial clearances.

Obtains information from patient health insurance or managed care identification card. Completes all registrations in a professional, accurate and customer-oriented timely manner. Performs and delivers excellent customer service to all customers - patients, physicians, ancillary service lines, and payers. Maintains Baptist Health Care goals of scheduling, registration accuracy, insurance verification, pre-registration, pre-certification, up-front collections, and other healthcare industry standards or trends. Meets current regulatory and compliance standards, such as HIPPA and Identity Theft "Red Flag Rules" by ensuring all patients are properly identified prior to scheduling. Follows the hospital exposure control plans/bloodborne and airborne pathogens. Reviews and updates the patient's account to ensure the organization has accurate and current information to process claims and to obtain payment including complete documentation of benefits, authorization information, and patient financial responsibility including other insurance changes as required. Tracks productivity and provides cumulative reports on a daily, weekly, or monthly basis, as required by department. Attends all required safety training programs and can describe his/her responsibilities related to general safety, department/service safety, and specific job related hazards.

Assist in other duties as assigned to support the operational needs of the department and organization. May be required to remain on campus immediately before, during, and after severe weather and/or disasters.