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Business Office Representative/Insurance Verifier

Universal Health Services

Job Code:
Universal Health Services
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Job Details

Business Office Representative/Insurance Verifier

Job Code:  240220
Facility: Kingwood Pines Hospital
Location: HOUSTON, TX US Southern
Region: Southern
Travel Involved: None
Job Type: Full Time
Job Level:  Experienced (Non-Manager)
Minimum Education Required: High School or equivalent 
Skills: Health Care -> Behavioral Health, Patient Admissions
Customer Service -> Phone Support, Face-to-Face Support
Administration -> Heavy Phones
Category: Office/Clerical
FTE: 1.0
Position Summary:

Position Summary
Universal Health Services, Inc. (UHS) is one of the nation’s largest and most respected health care management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 65,000 employees. The UHS business strategy is to build or purchase health care properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion.

Kingwood Pines Hospital a 116 bed facility located in the beautiful residential Kingwood community. We are located about 30 miles northeast of the Houston Medical Center. The hospital provides 24-hour emergency services. We serve children, adolescents, adults for psychiatric and behavioral health. The hospital also has services in intensive outpatient and partial hospital program services. Kingwood Pines Hospital currently has a Business Office Representative/Insurance Verifier position available.

Kingwood Pines Hospital offers full-time staff a robust benefits package to include: Health and Prescription Coverage, Dental, Vision, Long-term Disability, Short-term Disability, Life, AD&D, Flexible Spending Accounts, 401K with matching contributions, Stock Purchase Plan, Employee Assistance Program, Tuition Reimbursement Assistance, Paid Time Off, Legal Plan, Personal Accident Insurance, Long-Term Care Insurance, Critical Care Illness, Accident Coverage, Student Loan Refinance Program, Auto and Home Insurance and Pet Insurance.

The candidate selected will be responsible for the following:

Position: Business Office Representative/ Insurance Verifier

Reports to: Business Office Director

Department: Business Office

Purpose: To verify primary and secondary insurance coverage. Notifies all relevant parties and explains insurance benefits. Reviews insurance certification letters and ensures authorization numbers are entered on patient accounts prior to billing.

1. Schedule and perform regular and timely verification (telephone and online) on all assigned accounts and document associated activity in billing system verification notes.
2. Daily review of all Master File guidelines, as identified during routine activities, inform management of necessary changes to ensure the integrity of future billing transactions.
3. Confirmation of patient primary and secondary insurance.
4. Participate in interdepartmental and interdepartmental meetings, as requested.
5. Verifies active insurance coverage and obtains benefit information for all insurances covering patient
6. Informs patients on their deductible, coinsurance and copay responsibilities
7. Verifies patient insurance coverage in Medicare Eligibility Tool (DDE).
8. Knowledge of Medicare and Medicaid Guidelines
9. Document with demographics and insurance information
10. Check patient collections status for patient responsibilities from previous visits
11. Stay current on industry, benefits, product and regulation updates.
12. Perform various duties as assigned by management
13. Obtain upfront cash collection goal
Essential Functions
1. Calls patients to collect Co-payments and deductibles prior to outpatient services being rendered
2. Assist with Medicaid applications
3. Speak with patients and family at time of admit for collection of copay, deductibles, and coinsurance
4. Establish payment arrangements
5. Screening for Charity
6. Must have full capability to perform in a fast pace environment

Customers Served:
All hospital staff, medical staff, allied professional staff, external information requestors, and patients and their families.


QUALIFICATIONS: Have the ability to read, write legibly; ability to perform mathematical problems in order to determine patient’s financial responsibility; ability to orally communicate with staff, patients, and the public courteously; ability to concentrate on task in high traffic area; ability to meet deadlines and set priorities, ability to be flexible in work hours in order to meet patient and organizational operating needs. Ability to type accurately. Knowledge of basic computer functions and programs. Knowledge of the use and operation of normal office equipment, e.g., fax, copier, telephone, 10-key calculator. Ability to interact with co-workers and public courteously and professionally.

EDUCATION: High school or equivalent. Some college preferred.

• Current Texas Driver’s License
• Current CPI certification

EXPERIENCE: Minimum of two (2) years verification experience, preferably in a psychiatric setting.

Exposure Category: Category III – Tasks that involve no exposure to blood, body fluids, or tissues. Category 1 tasks are not a condition of employment.

Other Hazards: May participate in therapeutic crisis intervention with physically aggressive patients which may involve some personal risk. May encounter some chemicals listed in the MSDS sheets. Travel by car and/or air.

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