Insurance Eligibility Verification Specialist

UCF Clinical•Orlando, FL

5d•Onsite

About The Position

The Insurance Eligibility/Verification Specialist provides various administrative and office support functions for a clinical operation. This role is responsible for obtaining needed verifications, referrals, or authorizations for office visits, contacting insurance companies to verify coverage and ensure provider participation, and researching and resolving eligibility errors. The specialist will verify insurance by web or telephone to determine covered/non-covered services, calculate patient cost, and assist patients with insurance questions. They will identify inconsistencies with patient information and insurances to ensure an efficient workflow, discuss benefits and patient responsibility costs for office visit appointments, and answer telephone inquiries. Maintaining files with referral slips, authorizations, and insurance slips is also a key responsibility. The role requires adherence to HIPAA guidelines and regulations, including annual HIPAA training. The position may involve other job-related duties as assigned and attendance at required staff meetings and in-service sessions.

Requirements

A high school education or GED.
1+ years of relevant experience.
Knowledge of spreadsheet applications.
Excellent oral and written communication abilities.
Good interpersonal and public relations skills.
Solid problem-solving skills.
Attention to detail.
Well organized.
Courtesy, tact, and diplomacy are essential elements of the job.
Work involves much personal contact with others inside and/or outside the organization for purposes of giving or obtaining information, building relationships, or soliciting cooperation.

Nice To Haves

Previous insurance verification experience preferred.
eCW experience preferred.

Responsibilities

Obtains needed verifications, referrals, or authorizations for office visits.
Contacts insurance companies to verify coverage and ensure provider participation.
Researches and resolves eligibility errors.
Verifies insurance by web or telephone to determine covered/non-covered services.
Calculates patient cost and assists patients with insurance questions.
Identifies inconsistencies with patient information and insurances to ensure an efficient workflow.
Discusses benefits and patient responsibility costs for office visit appointment.
Answers telephone and provides information.
Maintains files with referral slips, authorizations, and insurance slips.
Performs other job-related duties as assigned.
Attends required staff meetings and in-service.
Adheres to HIPAA guidelines/regulations/annual HIPAA training.