Insurance Verification Specialist

Job Summary

The Insurance Verification Specialist will review patient insurance information and verify in advance the treatments that their policies will cover. They then call insurance companies and send the proper documentation to verify authorizations for procedures which require them.

Essential Job Functions and Responsibilities

• Enter data and validate patient information.
• Researches and corrects invalid or incorrect patient demographic information such as invalid insurance policy number to ensure proper billing.
• Determines member benefit coverage.
• Monitor and verify insurance information for individual patient visits and procedures.
• Communicate with patients about co-pays, benefits, coverage, and care authorization.
• Contacts providers with authorization, denial, and appeals process information.
• Assists in educating and acts as a resource to scheduling department.
• Works and assists with the billing department in researching and resolving rejected, incorrectly paid, and denied claims as requested.
• Responds professionally to all inquiries from patients, staff, and payors in a timely manner.
• Accurately documents patient accounts of all actions taken

Qualifications

• Strong work ethic and sound judgment
• Proven written and verbal communication skills
• Natural curiosity to pursue issues and increase expertise
• Demonstrated knowledge of insurances
• Two to four years related experience and/or training in insurance verification
• Two to four years of experience in medical billing
• Two to four years of experience in authorizations
• Knowledge of CPT and ICD10 codes.
• Excellent computer, multi-tasking and phone skills.
• The ability to work well under pressure (most of the paperwork is time sensitive).
• Must successfully pass a background check.

Additional Information

In accordance with HIPAA, this position must maintain the confidentiality of the patient in all circumstances as well as company confidentiality. Ensures the confidentiality of data collected and stored is maintained.

This description is intended to provide basic guidelines for meeting job requirements. Responsibilities, knowledge, skills abilities, and working conditions may change as needs evolve.

Note: This is a 1099 contractor position