Insurance Verification & Authorization Agent

Optimus Health Care • Stamford, CT

7d • Hybrid

About The Position

Optimus Health Care is seeking a Part-Time Insurance Verification & Authorization Specialist for its Behavioral Health department in Stamford, CT. This role is crucial for ensuring a smooth insurance and authorization process for patients, working closely with providers and clinical staff. The specialist will verify demographic and insurance information, contact insurance companies to confirm coverage, explain benefits to patients, and ensure authorizations are in place for services. This position acts as a liaison between patients, providers, and other involved parties, linking referrals for identified visits and ensuring timely payment for services. The role requires strong computer skills, familiarity with EMR is helpful, and a commitment to patient privacy. Flexibility to work at other Optimus Health Care sites is also necessary.

Requirements

• Great computer skills.
• Familiarity with EMR, helpful.
• Commitment to maintenance of patient privacy
• Flexibility to work at other OHC sites as necessary.
• High School diploma/GED
• five years experience preferred, preferably in a health care setting.

Nice To Haves

• Associates degree preferred.
• Bi-lingual Helpful

Responsibilities

• Responsible and accountable for verification of insurances to ensure billing of services.
• Review appointment schedules to identify insurance for verification, with particular insurance plans.
• Verify insurance coverage, copays and deductibles through employer, insurance carrier, and/or on line verification including the amounts “met to date” and any pre-authorization requirements.
• Verify coordinate of benefits in using the “birthday rule”, if patient is a minor.
• Update patient notes in the system with pertinent insurance changes or concerns, as a means to ensure account history is available for respective departments.
• Works closely and assists the Practice Manager with related special projects as necessary, including billing participation in performance improvement initiatives
• If patient qualifies for entitlement refer (by task) to FCC.
• Responsible to communicate with patient on insurance coverage concerns and any additional information required by carrier to process payment.
• Perform other related duties as required.

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Education Level: High school or GED