Insurance Change Specialist

VieMed Healthcare • Lafayette, LA

15h

About The Position

The Insurance Change Specialist is responsible for managing patient demographic and health insurance information, including collecting co-pays and verifying insurance benefits. This role involves understanding and providing insurance breakdowns, obtaining prior authorizations when required, and effectively interpreting medical documentation. The specialist will also resolve front collection accounts, maintain accurate documentation in the computer system, and foster effective communication with patients, physicians' offices, and internal teams. Additional duties include handling patient and insurance calls, faxing, and emailing, and reporting concerns to the Manager/Supervisor or Revenue Cycle Manager.

Requirements

• High School Diploma or equivalent.
• Learns and maintains knowledge of current patient database and billing system.
• Verifying Insurance for all products.
• Understand Insurance benefit breakdown of deductibles and co-ins.
• Understand Insurance Medical and Payment Policies.
• Knowledge of Explanation of Benefits from insurance companies.
• General knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid.
• Working knowledge of CPT and ICD-10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
• Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.
• Utilizes initiative while maintaining set levels of productivity with consistent accuracy.
• Minimum of 1 year of insurance verification or authorizations required.
• Superior organizational skills.
• Proficient in Microsoft Office, including Outlook, Word, and Excel.
• Attention to detail and accuracy.
• Effective/professional communication skills (written and oral).

Nice To Haves

• 2-4 Years in DME or Medical Office experience preferred.

Responsibilities

• Obtains patient demographic and health insurance information; collects co-pay(s) when appropriate.
• Verifies and records insurance benefits with the ability to understand and provide insurance breakdowns.
• If required by payer(s), obtains prior authorization &/or follows up on authorization daily.
• Able to read through and understand medical documentation effectively.
• Resolves Front Collections accounts as well as documenting within computer system appropriately.
• Establishes and maintains effective communication and good working relationships with patients/family, physicians’ offices, and other internal teams for the patient’s benefit.
• Performs other clerical tasks as needed, such as Answering patient/Insurance calls, Faxing and Emails.
• Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Revenue Cycle Manager and Supervisor.
• Other responsibilities and projects as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees