Insurance Representative

Description

 JOB SUMMARY

The Revenue Cycle Management Insurance Representative is responsible for verification and validation of insurance information, maintaining active physician orders and/or referrals, obtaining prior authorizations, tracking insurance visit limitations and communication with families regarding benefits, limits, and out of pocket expenses. The Insurance Representative will follow established processes to ensure all aspects of the role are completed in a clear and concise manner. This role will work closely with Accounts Receivable positions for denials related to authorizations and/or insurance requirements.  Hours are Monday-Friday 8am - 5pm.

Essential Duties and Responsibilities

• Verify order to treat and/or referral from referring provider is active and request renewal when needed. 
• Verify insurance benefits and authorization requirements for scheduled services.
• Communicate insurance benefits, requirements and expected out of pocket expenses with family and updated appointment payments accordingly.
• Provide financial assistance information to families when appropriate.
• Provide benefit verification form to Front Desk for family signature at appointment.
• Refer to Account Management Lead when a payment plan may be needed due to high deductible.
• Obtain and maintain authorizations when required by insurance based on benefits. 
• Notify therapist if insurance requires additional information for authorization requests.
• Handle insurance issues with agility and efficiency to maximize revenue potential.
• Maintain positive customer relationships with clients/guarantors.
• Prompt and regular attendance is required for this position.
• Other duties as assigned.

Requirements

Educational, Experience, and Licensure Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the education and experience required.

• High School Diploma or equivalent, required.
• 1-2 years experience in medical insurance is preferred.
• Proficiency of EMR/EHR preferred.
• Proficiency in Microsoft Word, Excel, and Outlook is required.

  Required Knowledge and Skills 

• Analytical Thinking – the ability to analyze information and use logic to address work-related issues and problems. 
• Attention to Detail – job requires being careful about detail and thorough in completing assigned tasks. 
• Data Entry – ability to enter accurate information into a computer program or system. 
• Dependability – job requires being reliable and responsible to fulfill obligations. 
• Integrity – job requires being honest, ethical, and the ability to maintain confidentiality. 
• Listening – ability to listen effectively and obtain information from others. 
• Organizational Skills – prioritize, organize, and accomplish assigned tasks by deadlines. 
• Speaking – the ability to communicate orally to convey information effectively. 
• Time Management – managing one's own time to produce results. 
• Writing – ability to communicate effectively in writing to convey information.