Position Description

TMC HealthCare

TMC HealthCare is Southern Arizona's regional nonprofit hospital system with Tucson Medical Center at its core. Each day staff comes to work to use their skills and expertise to improve the health of the entire community, from birth to the end of life.

Patient Access Insurance Verification Rep - Enterprise Scheduling
Job Category Clerical
Schedule Full time
Shift 1 - Day Shift
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SUMMARY:

Contacts insurance payors to secure eligibility, benefits and authorizations for services rendered to ensure financial reimbursement for the facility. 

ESSENTIAL FUNCTIONS:

Exhibits excellence in customer service through appropriate attitude and interaction with all patients, visitors and staff; adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication. 

Obtains co-pay, co-insurance, deductibles and out of pocket maximum for patient and/or guarantor for anticipated services and admissions.

Ensures completion of financial documentation in accordance with TMCH’s credit and collection policies.

Interacts with physicians and/or physicians’ office staff to secure diagnosis, procedure details or authorization information.

Performs patient registration activities to ensure accurate financial and biographical data and documentation have been obtained and properly entered into hospital records, as applicable. 

Completes insurance processing; including account creation, insurance verification, notification, and authorization functions.

Documents all notification, authorization and eligibility information in the registration systems, uses electronic verification tools and web-based resources.

Adheres to TMCH organizational and department-specific safety, confidentiality, values policies and standards.

Performs related duties as assigned.

MINIMUM QUALIFICATIONS

EDUCATION:  High School diploma or General Education Degree (GED), completion of vocational medical office training desired, or an equivalent combination of relevant education and experience.

EXPERIENCE:  Two (2) years of medical office and/or hospital experience to include six (6) months healthcare eligibility and benefit analysis.

LICENSURE OR CERTIFICATION: None required.

 

 

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