Insurance Verification Specialist

Description

As a key member of Patient Financial Services, the Insurance Verification team is responsible for all aspects of insurance eligibility, and benefit verification, including customer service, with the objective of minimizing controllable denials and maximizing the clean claim rate.

The Insurance Verification Specialist role follows prescribed policies and procedures, performs a variety of verification tasks using standard healthcare guidelines. Obtains insurance coverage information from patient, and payor, utilizing all available tools, including medical documentation, and contract information to select the appropriate insurance policy/plan. Obtaining accurate benefit information to identify patient financial liability.

Duties include:

• Verify in and out-of-network insurance benefits via phone calls to insurance companies and checking insurance company online portals.
• Update patient accounts with accurate insurance information.
• Communicate with patients regarding their insurance coverage and any out-of-pocket expenses.
• Work closely with medical billing team to ensure claims are processed correctly.
• Maintain patient confidentiality and comply with all HIPAA regulations.
• Utilize medical billing and coding knowledge to accurately verify insurance information.
• Approve or decline orders based on the insurance benefits and threshold limits
• Mark the status of orders in spreadsheets
• Follow up on patient balances.

Position Requirements:

• High school diploma
• 1+ years of medical revenue cycle management
• 2+ years in a medical office setting with medical benefits verification & prior authorization experience preferred
• 1+ years of customer service or inbound call center experience required
• Prior ophthalmology experience preferred
• Strong attention to detail and accuracy in verifying insurance information.
• Ability to work at a fast pace with minimal supervision
• Familiarity with managed care plans and insurance procedures.
• Working knowledge of third-party payer requirements, insurance benefits and coverage
• Strong verbal and written communication skills

What we Offer:

• Medical, Dental & Vision Insurance
• 401K matching
• Life Insurance
• Generous PTO and paid company holidays
• Career ladders and growth opportunities

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