We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The Insurance Verifier oversees all admissions and confirms proper verification of patient’s coverage. Reviews all inpatient admissions to verify and re-verify plans, ensures plan codes are correct, and appropriately documents in systems.

Job Responsibilities/Duties

• Reviews all inpatient and outpatient admissions, including daily Managed Care report from the previous day, to ensure insurance verifications are accurate and complete. Contacts the insurance carrier to verify eligibility for the billing department. Ensures health plans are contacted in an appropriate and timely manner when pre-certification is required.
• Enters insurance verification information into Optimum and All Scripts. Ensures all insurance information is current and accurate. Re-verifies all insurance information on the 2nd and 16th of each month. Appropriately notifies leadership and case management of any changes in coverage. Contacts contracted vendor to screen patient for insurance coverage.
• Reviews the daily Bill Hold Report for any accounts which do not have verification completed, appropriately completes verification, and enters initials to document/verify completion.
• Maintains confidentiality with regard to patients, families, employees, and visitors.

Qualifications

Minimum Education: High School Diploma or GED required. Bachelors Degree preferred.

Minimum Experience: One (1) year of admitting/registration office experience required. Basic Understanding of Medical Terminology required. Excellent written and verbal communication skills in English. Strong time management skills. Ability to multitask and maintain a work pace appropriate to workload. Computer literacy and proficiency. Must demonstrate customer service skills appropriate to the job. Bilingual skills to communicate effectively with patients and families preferred.

Req. Certification/Licensure: None.

Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

• Company 401K
• Medical, dental, vision insurance
• Paid time-off
• Life insurance

How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm