MHC Healthcare is seeking an Insurance Verification Specialist to join the MHC Medical team at the Marana Main Health Center, located in the heart of Marana, AZ. The Insurance Verification Specialist will identify, verify, screen and ensure accuracy of data entry for each patient provided services through available programs at Marana Health Center (MHC). MHC Healthcare is a Federally Qualified Community Health Center (FQHC), with 17 sites in Tucson and Pima County. Our mission is to improve our Community by providing exceptional, whole-person healthcare.

The Anticipated Schedule:

• Monday - Friday 8 a.m. - 5 p.m.

The following qualifications are required:

• High school diploma or equivalent; required.
• One (1) year of experience working in a medical office with relevant experience; required.
• Knowledge of health insurance companies, benefits, policies and automated verification processes; required.

The following qualifications are preferred:

• Associate’s degree; preferred.
• Related experience may substitute for education on a two-to-one year basis
• Spanish speaking; preferred
• Fingerprint Clearance Card through the Arizona Department of Public Safety (or ability to obtain upon hire)

Equivalent combination of education and experience may be considered if applicable and must be directly related to the functions and body of knowledge required to successfully perform the job.

This position has the following supervisory responsibility:

• Does not supervise others.

The ideal candidate will also possess the following knowledge, skills, and abilities:

• Ability to work in a culturally diverse environment.
• Ability to provide excellent customer service.
• Ability to work under stressful situations.
• Ability to multi-task.
• Computer literate.
• Detail oriented and open to learning new skills.
• Excellent telephone etiquette and communication skills.
• Ability to accept and make calls at a workstation.

Duties and Responsibilities:

• Verifies patient insurance eligibility and benefits using any of the automated systems, web-based utilities, automated voice verification lines and calling on the telephone.
• Closely coordinates with other departments, including Central Business Office (CBO), Front Office Reception, Medical, Outreach, Training Department and Management, to facilitate the financial clearance process and service payment.
• Informs families of the availability of publicly financed healthcare programs and insurance.
• Coordinates with Outreach staff to assist clients with establishing or recertifying for AHCCCS, a Qualified Marketplace plan or Sliding Fee Schedule coverage.
• Performs eligibility screening and ensures proper documentation is placed in the patient’s Electronic Medical Record (EMR).
• Updates, edits and confirms accurate financial account information on each patient visit.
• Ensures the capture of all necessary information needed for prompt and accurate payment of services provided, including scanned copies of insurance cards, Patient Profile and Authorizations for Treatment and Patient IDs.
• Ensures and promotes 100 percent accuracy levels in the capture of all demographic and billing information for each service provided.
• Attends regular, ongoing training and development to identify insurance changes and opportunities within the insurance verification process.
• Works within MHC’s EMR system for documenting the results of all patient insurance verification.
• Understands the difference between Primary, Secondary and Tertiary insurance and when and how to validate it for each patient receiving care services from MHC.
• Watches for changes and trends regarding insurance verification that may hamper the prompt submission or collection of submitted claims for patient services.
• Reports any identified problems to assigned manager to ensure immediate reviews are conducted and changes made where required.
• Participates in in-service and education regarding Quality Improvement or required job-focused education.
• Uses appropriate incident reporting procedures when documenting unsafe or problematic incidents involving patients, clients and/or staff.
• Completes Incident Report accurately and follows procedures completely.
• May be required to make or assist with daily patient appointment call reminders for future appointments.
• Occasional back-up/Coverage for Front Office Receptionist
• Performs all other related duties as assigned.

Benefits:
MHC Healthcare’s vision is to be the premier provider and employer in community health. To support our mission and vision in our community, MHC Healthcare believes health and well-being must start at home. Therefore, employees have many opportunities to care for our own health and wellness with benefits such as:

• Medical, Dental, and Vision
• 403(b) with employer contribution
• Short-term disability and other benefits
• Paid time off including 11 holidays plus vacation and sick leave accrual
• Paid bereavement, jury duty, and community service time
• Employee discount for medical services ($500 per year for full-time)
• Education reimbursement ($3,000 per year for full-time)

MHC Healthcare will recruit, hire, train, and promote persons in all job titles without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or an other characteristic protected by law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.


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