Insurance & Benefits Verification Specialist
About The Position
NEXus Pain Center is looking for a motivated, knowledgeable, experienced, multi-task expert, detail-oriented, organized person to process insurance paperwork and verify benefits for pain management patients. This role involves verifying insurance benefits, obtaining authorizations/re-certifications, and providing appropriate follow-up communication with patients regarding their insurance plan benefits. The specialist will review physician notes and injection orders for accuracy, participate in skill development, and maintain a positive attitude within a teamwork-oriented clinic environment. A key responsibility is the pre-certification of patient insurance before care is scheduled. The role requires proficiency in obtaining medical benefits via phone and insurance portals, the ability to thrive in a fast-paced environment, and a strong understanding of insurance coverage and medical terminology.
Requirements
- Excellent verbal and written communication skills to include superior interpersonal and patient contact skills and excellent telephone manners
- Minimum of two years of experience with scheduling and insurance billing for medical services with general knowledge of ICD10 and CPT codes
- General knowledge of office procedures, equipment, and comprehensive computer skills
- Ability to follow doctors’ orders and thorough knowledge of injection therapy practice
- Work under minimal supervision and have ability to remain calm and exercise good judgment in stressful situations
- EMR experience needed
- Previous experience as front office staff in physician’s office
Nice To Haves
- eClinical (ECW) experience a plus
Responsibilities
- Verify all insurance
- Ensure all patients insurance benefits are updated and active
- Scan insurance documents into patients’ charts
- Call patients about updating their VA and Tricare referrals
- Fax veteran referral for renewal
- Provide patient with a 30-day referral reminder and have them sign it
- Call insurance advisor on updating benefits
- Education liaison for patients on insurance benefits and coverage
- Verify insurance benefits, obtain authorizations/re-certifications
- Provide appropriate follow-up communication with patients for adherence to Insurance plan benefits
- Review ordering physician note and injection order to ensure accuracy and consistency
- Participate in skill development and training though in-service programs to enhance knowledge level and to ensure mastery of processes
- Maintain a positive attitude and convey enthusiasm
- Involve in teamwork approach to responsibilities and activities within the clinic
- Responsible for pre-certification of patient insurance before care or treatment is scheduled
- Proficient in obtaining medical benefits by phone and by insurance portals
- Must be able to keep up with a fast-paced working environment
- Must demonstrate knowledge of Insurance coverage
- Detail oriented
Benefits
- Medical, Dental and Vision Insurance begins day 1
- Profit sharing and 401(k) benefits
- Paid company holidays
- PTO accrual
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
