Job Description

Employment Status:
Full time
Job Function:
Business Support
Department:
401606 Patient Access - Clerical
Shift Hours / Days:
Mon-Fri 9am-5:30pm
Hours / Pay Period:
80

Advocate, Patient Access (Insurance Verifier)

 

We Fight Cancer: Care That Never Quits®

Cancer Treatment Centers of America® (CTCA®) delivers an extraordinary patient experience we call Patient Empowered Care®. We deliver state-of-the-art, high quality care through an integrative model where a team of experts puts patients at the center of their own care. Every day, you will help patients win the fight against cancer. Every day is challenging and rewarding beyond your imagination.

 

A Culture of Teamwork, Empowerment & Development

CTCA provides Stakeholders with exceptional support and easy access to a wide range of tools and resources they need to bring the best of themselves, every day. Our benefits, wellness, and compensation programs lead the market. We provide extensive training and career development opportunities that encourage professional and personal growth—it is a point of pride. We empower our Stakeholders to deliver the highest standard of care, which we call the Mother Standard®.

 

Job Summary/Purpose:

The Insurance Verifier reviews and evaluates a prospective and current patient’s insurance coverage after obtaining the benefits from an interview process of over 50 detailed questions with the patient’s insurance payer. The Insurance Verifier uses the quoted benefit information to facilitate a decision regarding a patient’s eligibility to be treated at CTCA while insuring that the CTCA Patient Financial Acceptance policy and specific site exception policies are applied. The Insurance Verifier determines when a patient should be escalated to site CFO’s for Administration Approvals. The Insurance Verifier documents individual patient benefits into the database repositories for insurance data which serve as the databases for communicating benefit information to both prospective and current patients and for insuring accurate and complete billing, correct reimbursement rates, pre-certification requirements, and maximized collections. The Insurance Verifier communicates daily with OIS, OIS Leadership, Care Managers, Registration Stakeholders, Pre-Certification Coordinators, Site CFO’s, Site VP’s of Finance, Billers, CAR’s, PACR’s and Account Management Specialists. The Insurance Verifier reports directly to the Insurance Verification Supervisor.                                                        

Minimum Qualifications:

  • Must be a high school graduate or equivalent with strong analytical skills and good figure aptitude. Associates Degree preferred.

  • Recommended minimum of 1-3 years experience in insurance verification, insurance benefits, registration, billing and/or collection, in a healthcare / physician office setting or professional environment.

  • Familiar with all required computer applications (CRM, AMPFM, Hyland OnBase, Pivot), office equipment and maintains accurate patient demographics per HIPPA guidelines, insurance information, and routinely updates CRM notes or AMPFM account comments of each record worked.

  • Able to recognize and have a general understanding of cancer diagnoses, contract terms, insurance terminology (IE: Coordination of Benefits, Letter of Credible, and Medical Review), reimbursement methods, and payer structures.

     

    The Best Place to Work

     

    We call ourselves Stakeholders because we all have a stake in the care and success of every patient. Today, CTCA Stakeholders deliver healing and hope to patients fighting complex and advanced cancer in Atlanta, GA, Chicago, IL, Philadelphia, PA, Phoenix, AZ and Tulsa, OK.  Each of our hospitals earned a Best Place to Work distinction and receives numerous accreditations that celebrate our culture of clinical quality, innovation, high performance and wellness.

     

    Beyond The Resume, What We Look For

     

    We select people with talent—people who thrive in an environment of continuous improvement. We are creative and resourceful problem solvers. We are inventors and innovators. As a CTCA Stakeholder, you make the difference in the life of a patient.

     

    Do you see yourself working with a passionate team in a dynamic, high growth environment?  Visit www.cancercenter.com/careers  to begin your journey.