Insurance Change Specialist

VieMed Careers•Lafayette, LA

About The Position

The Insurance Change Specialist obtains patient demographic and health insurance information, collects co-payments when appropriate, verifies and records insurance benefits, and provides insurance benefit breakdowns. The role obtains prior authorizations when required by payers and follows up on authorizations daily. It also reviews medical documentation, resolves Front Collections accounts, and documents work in the computer system. The specialist maintains effective working relationships and communicates with patients and families, physicians’ offices, and internal teams. Additional clerical tasks may include answering patient and insurance calls, faxing, and email. The position communicates concerns and issues to the Revenue Cycle Manager and Supervisor and performs other assigned responsibilities and projects.

Requirements

High school diploma or equivalent.
Minimum of 1 year of insurance verification or authorization experience.
Learn and maintain knowledge of the current patient database and billing system.
Ability to verify insurance for all products.
Understanding of insurance benefit breakdowns, including deductibles and co-insurance.
Understanding of insurance medical and payment policies.
Knowledge of insurance company Explanation of Benefits.
General knowledge of government, regulatory billing, and compliance regulations and policies for Medicare and Medicaid.
Working knowledge of CPT and ICD-10 codes, HCFA 1500 and UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, and insurance benefits.
Sufficient knowledge of policies and procedures to accurately answer internal and external customer questions.
Ability to use initiative while maintaining established productivity levels and consistent accuracy.
Superior organizational skills.
Proficiency in Microsoft Office, including Outlook, Word, and Excel.
Attention to detail and accuracy.
Effective and professional written and oral communication skills.

Nice To Haves

2–4 years of experience in DME or a medical office.

Responsibilities

Obtain patient demographic and health insurance information.
Collect co-payments when appropriate.
Verify and record insurance benefits and provide insurance benefit breakdowns.
Obtain prior authorizations when required by payers and follow up on authorizations daily.
Read and understand medical documentation.
Resolve Front Collections accounts and document work appropriately in the computer system.
Maintain effective communication and working relationships with patients and families, physicians’ offices, and internal teams.
Perform clerical tasks as needed, including answering patient and insurance calls, faxing, and emailing.
Communicate appropriately and clearly with the Manager, Supervisor, and other superiors.
Report concerns or issues directly to the Revenue Cycle Manager and Supervisor.
Perform other responsibilities and projects as assigned.