Insurance Verification Representative II - Central Insurance Verification Clinic

Position Title: Insurance Verification Representative II - Central Insurance Verification Clinic Team Department: Admitting Job Description: The Insurance Verification Representative II is responsible for timely and accurate pre-registration, insurance verification, and patient demographic updates. This role ensures compliance with payor requirements and supports the revenue cycle through effective communication and documentation. This role serves as a lead within the department by performing advanced duties and assisting with staffing, quality assurance, reporting, and training. Essential Responsibilities Responsibilities listed in this section are core to the position. Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position. Perform pre-registration and insurance verification for inpatient and outpatient services. Follow scripted benefits verification and pre-certification format in the EMR and document results. Contact patients to confirm or obtain missing demographic information, quote/collect patient cost share, and provide appointment instructions. Assign insurance plans accurately and perform electronic eligibility confirmation. Complete Medicare Secondary Payor Questionnaire as applicable. Calculate patient cost share and arrange payment or collection via phone. Research patient visit history to ensure compliance with payor-specific rules (e.g., Medicare 72-hour rule). Communicate with physicians an