Insurance Benefits Verification Specialist, RCM

Mayfield Clinic•Cincinnati, OH

3d•Onsite

About The Position

This Specialist will join the insurance verification team and be responsible for patient registration and eligibility verification, benefits investigation, cost estimation, and other tasks related to patient account balances. The Revenue Cycle Management (RCM) team is seeking an individual with experience in insurance eligibility and/or claims processing, as well as critical thinking skills, attention to detail, and the ability to learn quickly and adapt to a dynamic environment.

Requirements

High School Diploma required
Two years of experience in healthcare administration/revenue cycle
Demonstrates excellent customer service
Ability to convey empathy
Strong problem-solving, problem-prevention, and decision-making skills
Ability to manage and prioritize multiple tasks in a fast-paced environment
Excellent oral and written communication skills
Ability to maintain composure and restore calm in a stressful situation
Uses good judgment and diplomacy when dealing with others
Desire and ability to work in a team environment
Computer proficient with the ability to learn multiple software applications
Ability to work with minimal supervision

Nice To Haves

CRCR Certification preferred

Responsibilities

Execute actions on patient account details, including insurance eligibility and benefits verification, cost estimation, answering patient calls, and performing patient account follow-up tasks in the assigned area of the Revenue Cycle process.
Verify patient eligibility and benefits in an accurate, timely manner; prepare cost estimates and pre-collect on scheduled services, register new patients, prepare payment plans, and perform other tasks as required.
Make all necessary corrections to patient accounts in collaboration with the claims follow-up team.
Research unpaid patient balances and communicate with patients and clinical office staff as needed to pursue payment.
Ensure that questions and requests for information are addressed in a timely & professional manner to ensure resolution & reimbursement.
Ensure timely & accurate posting of patient payment information, and follow up with patients as needed to ensure full, expected reimbursement for services provided.
Maintain documentation and update our practice management system for appropriate claims submission & other pertinent information to identify action taken.
Make necessary adjustments as appropriately required by plan reimbursement & company policy.
Prioritize accounts based on aging and outstanding dollar amounts or as directed by management.
Research & initiate requests for refunds for accounts with credit balances.
Answer & initiate phone inquiries regarding bills, charges, claims, and account status.
Update data in the practice management system as required.
Contribute to the team environment by performing other duties as assigned.