About Surgery Center of Appleton

Conveniently located in the Trasino Landing shopping center at 1616 N. Casaloma Dr. in Appleton, Wis., the Surgery Center of Appleton is a partnership between Ascension Wisconsin, Regent Surgical Health and Wisconsin Spine and Pain. The Surgery Center of Appleton is an ambulatory surgery center established to provide personalized care and treatment for patients suffering from chronic pain.

Our Appleton location will be transitioning to the NEW (Northeast Wisconsin) area this summer as part of our continued growth and expansion. This move will support enhanced operations, collaboration, and long‑term opportunities for our team.

NEW Address:
1550 Midway Place Suite 100

Menasha, WI

About Regent Surgical Health

Since 2001, Regent Surgical Health has been a leader in developing and managing successful surgery center partnerships between hospitals and physicians. We continually improve and evolve the ASC model based on changing market conditions to stay ahead of emerging trends. From this vantage point, our team has developed proprietary ASC ownership models that give both physicians and hospitals what they need to ensure long-term clinical and financial success. 

POSITION SUMMARY:

Under the direction of the Business Office Manager, the Insurance Verification Specialist ensures patients have valid and adequate insurance coverage for surgical services. They verify patient information, insurance eligibility and benefits, and authorizations and referrals before treatment including communication regarding financial responsibilities. This role requires strong communication with patients and physicians’ offices, attention to detail, and knowledge of healthcare insurance plans and billing procedures.

DUTIES/RESPONSIBILITIES:

• Verify insurance coverage by confirming patient’s insurance eligibility and benefits with various providers (HMOs, PPOs, Medicare, and Medicaid); document and update patient insurance details in the system and maintain up-to-date records.
• Investigate and resolve discrepancies in insurance information attached to patient account.
• Ensure valid authorizations were received from physician’s office for the scheduled procedure; confirm by contacting insurance companies and contacting physician’s offices in the event of missing authorizations.
• Communicate coverage details, and financial estimates to patients prior to services rendered; obtain payments for procedures; address insurance-related inquiries.
• Collect any outstanding balances; inform revenue cycle when account has outstanding insurance balance.
• Document all necessary information to the billing department for accurate claims processing.
• Adhere to HIPAA and other relevant regulations.
• Understand and apply ICD-10, CPT, and HCPCS codes when verifying coverage.
• Remain current on all case verification; standard operating procedure is two weeks prior to date of service.
• Notify the Business Office Manager in the event of insurance or authorization discrepancies or balances due.
• Run daily reports to ensure all cases are verified, authorized, and financial counseling is complete.
• Perform other duties as assigned.

EDUCATION/EXPERIENCE

REQUIRED:

• High school diploma or equivalent
• Insurance verification or billing experience in a healthcare environment
• BLS certification (as required by individual ASC policy)

PREFERRED:

• Two years of insurance verification or billing experience in a healthcare environment