Insurance Verifier - PRMC

Location Address:

2100 N Dr Martin Luther King Jr Blvd
Clovis, NM 88101-9412


Compensation Pay Range:

Minimum Offer $16.36
Maximum Offer $24.26
Now Hiring: Insurance Verifier - PRMC

Summary:

Will directly be responsible for the successful completion for all Scheduled and Nonscheduled patient accounts: pre-registration, insurance eligibility, benefits verification, payer plan code assignment, referral coordination and financial clearance. Responsible for independently resolving any insurance verification and financial clearance issue prior to and after an appointment; this involves contacting patients and insurance/third party payers to resolve eligibility and benefits issues and to initiate insurance appeals if necessary. Responsible for communicating with practice managers, clinicians, staff and patients to ensure that visits are appropriately registered, and meet all insurance billing requirements. Expected to notify the appropriate practice manager when patient accounts are at financial risk and to recommend options that will sustain the Hospital while ensuring financial reimbursement

Type of Opportunity: Full time
Job Exempt: No
Job is based: Plains Regional Medical Center
Work Shift: Days (United States of America)


Responsibilities:

• •Coordinates all aspects of account financial clearance, including pre-registration, insurance eligibility and benefits verification, referral coordination, and patient financial responsibility communication.
• •Accurately collects, verifies, and updates patient demographic, registration, and insurance information within hospital systems.
• •Responds to patient and payer inquiries regarding registration, billing, insurance requirements, and available services, routing concerns as appropriate.
• •Collaborates with patients, providers, practice managers, and third-party payers to resolve registration, authorization, and financial issues, including appointment rescheduling when necessary.
• •Maintains professionalism and effective communication while supporting patients from diverse cultural and socioeconomic backgrounds.
• •Prioritizes assigned accounts, completes follow-up activities, and documents work accurately to ensure timely financial clearance and billing compliance.
• •Escalates issues or potential risks to leadership in a timely manner and takes ownership of assigned accounts from start to resolution.
• •Assists with onboarding and training of new team members as needed.
• •Adheres to quality, productivity, and documentation standards to support departmental performance and organizational goals.

Qualifications:

• •High school diploma or GED required.
• •Minimum of one year of relevant healthcare experience preferred, such as patient registration, business office, medical office, or insurance verification.
• •One to two years of customer service experience required.
• •Strong interpersonal skills with the ability to work effectively with patients, the public, and all levels of staff and leadership.
• •Excellent organizational, multitasking, and prioritization skills required.
• •Proficiency in typing and 10-key data entry required.
• •Bilingual skills preferred.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

• Wellness
• Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

• Why work at Presbyterian?
• As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

• About Presbyterian Healthcare Services
• Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services