Insurance Verification Representative - Tennova Orthopedics - Turkey Creek - PRN

Job description

Job Summary The Insurance Verification Representative is responsible for verifying insurance benefits, eligibility, and authorization requirements to ensure accurate billing and reimbursement for procedures and services. This role interacts with physician offices, patients, and internal departments to coordinate insurance approvals, obtain necessary referrals and authorizations, and communicate patient financial responsibilities. The Insurance Verification Representative ensures compliance with payer guidelines and facilitates a smooth scheduling and billing process for patients. Essential Functions: - Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients to ensure coverage and minimize claim denials. - Confirms that the correct insurance package has been loaded into the patient's chart and updates records as needed. - Reviews provider schedules in the electronic medical record system to obtain referrals for HMO patients and authorizations for procedures and radiology testing. - Works with hospital radiology and scheduling teams to ensure all necessary authorizations are secured for upcoming procedures. - Reviews the authorization/r...