About The Position

This position is responsible for providing insurance verification for insured patients. The role involves responding to all internal and external phone calls regarding patients’ insurance verification inquiries. The specialist is responsible for confirming eligibility within a specific territory and ensuring that the collection of all managed care and third-party claims are followed up in accordance with department policies, procedures, and performance goals.

Requirements

  • High school diploma or GED required
  • 1+ years of Medical Health Insurance Plans, Medicare, Medicaid, Managed Care Plan and third-party liability guidelines experience required
  • 1+ years of insurance verification and/or billing and collections experience
  • 1+ years of basic knowledge of billing and collecting process
  • 1+ years of familiarity of medical and insurance terminology required
  • Proficient in computer applications
  • Able to handle stressful situations and hard deadlines
  • Excellent typing skills.
  • Excellent grammar and spelling capabilities.
  • Excellent phone skills
  • Ability to multitask
  • Legally authorized to work in the United States.
  • Conditional offer of employment is upon the successful completion of a background investigation and drug screen.

Responsibilities

  • Verifying specific benefit coverage and ensures appropriate data has been obtained and documented into the registration system to secure reimbursement.
  • Calling patients to confirm any missing details of insurance.
  • Works closely with all staff to assist in identification of patient responsibility.
  • Identifies accurate patient portions, in order to collect money at the time of service (including past due account balances).
  • Knowledge of websites utilized to verify insurance such as Availity, Navicure, Clearinghouses and other.
  • Strong computer and data entry skills.
  • Knowledge in billing CMS 1500 and ADA claims.
  • Corresponds with and assists vendors involved with patient accounts.
  • Reviews and prepares check requests for patient and insurance refunds.
  • Some billing duties may be assigned based on availability.
  • Expected to work 600+ encounters per week.
  • Actively supports and complies with all components of the compliance program, including, but not limited to, completion of training and reporting of suspected violations of law and Company policy.
  • Maintains confidentiality of all information; abides with HIPAA and PHI guidelines at all times.
  • Reacts positively to change and performs other duties as assigned.
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