Insurance Verification Specialist - Skilled in insurance portals, EMR/EHR systems

This is a remote position.

Mon - Fri 8 AM- 5 PM Georgia, US Time includes 1h unpaid break.

Key Responsibilities:

1. Insurance Verification:
   

   • Confirm patient insurance eligibility and benefits through online portals, phone calls, or electronic systems.
     
   • Identify coverage limitations, deductibles, co-pays, and out-of-pocket responsibilities.
     

2. Authorization Management:
   

   • Obtain pre-certifications and prior authorizations for scheduled procedures or treatments.
     
   • Track and follow up on pending authorizations to avoid delays in patient care.
     

3. Patient Communication:
   

   • Inform patients of their insurance coverage, out-of-pocket costs, and any issues with their policy.
     
   • Address patient inquiries regarding insurance verification in a professional and empathetic manner.
     

4. Documentation and Records:
   

   • Accurately input verified insurance information into the patient management system.
     
   • Maintain detailed records of verification and authorization activities.
     

5. Collaboration:
   

   • Work closely with clinical, billing, and scheduling teams to resolve discrepancies or coverage issues.
     
   • Liaise with insurance companies to clarify coverage details and resolve conflicts.
     

6. Compliance:
   

   • Ensure adherence to HIPAA regulations and company policies when handling sensitive patient information.
     
   • Stay updated on changes in insurance policies and guidelines.
     

Qualifications:

• Education: High school diploma or equivalent; post-secondary education in healthcare administration is a plus.
  
• Experience:
  • Previous experience in insurance verification, billing, or a related healthcare field preferred.
    
  • Familiarity with medical terminology and coding (CPT, ICD-10) is advantageous.
    
• Skills:
  • Strong attention to detail and accuracy.
    
  • Excellent communication and interpersonal skills.
    
  • Proficiency in using insurance portals, EMR/EHR systems, and Microsoft Office Suite.
    
  • Ability to work in a fast-paced environment and manage multiple tasks.
    

Key Competencies:

• Problem-solving and critical-thinking skills.
  
• Time management and organizational skills.
  
• Team-oriented mindset with a customer-focused approach.