Insurance Verification Specialist

M.I.N.D•Farmington Hills, MI

2d•$18 - $21•Onsite

About The Position

The insurance verification & benefit specialist is responsible for obtaining and verifying accurate insurance information, benefit validation, referrals and preservice collections. This role involves collecting and documenting patient demographic and financial data, analyzing insurance plans, and ensuring correct plan selection in the practice management software. The specialist will also collect and document insurance referrals, screen visits for medical necessity, issue Advance Beneficiary or Non-Covered Service notices, and provide cost estimates. Additionally, they will obtain information for third-party billing, screen self-pay and out-of-network patients, and provide information for financial counselors. The role also includes verifying provider participation status, educating the appointment call center, and assisting the billing department with claim resolution. Professional and timely responses to inquiries from patients, staff, and payors are essential.

Requirements

High School Diploma or GED.
Demonstrated knowledge of insurances
1+ year experience in insurance verification, including navigating websites for online benefit review.
Knowledge of CPT and ICD-10 codes.
Excellent computer, multi-tasking and phone skills.
The ability to work well under pressure (most of the paperwork is time sensitive).
Must successfully pass a background check and drug screen.

Nice To Haves

Maintains a professional relationship and positive attitude with co-workers, patients and all M.I.N.D staff.
Strives to learn more and receptive to new challenges and opportunities.
Displays enthusiasm toward the work and the mission of M.I.N.D.

Responsibilities

Collects and documents all required demographic and financial patient data.
Analyzes patient insurance(s), identifies the correct insurance plan, selects appropriate plan from practice management software and documents the correct insurance order.
Collects insurance referrals and documents in the practice management software.
Screens visits for medical necessity and issues Advance Beneficiary or Non-Covered Service notices as appropriate.
Provides cost estimates.
Obtains information from the patient if third party payers need to be billed (ie/workers compensation, auto insurance, etc).
Screens all patient self-pay & out of network patients and provides the appropriate cost estimates.
Provides information for follow-up and referral to the financial counselor as appropriate for outstanding balances.
Verifies participating status of providers.
Assists in educating and acts as a resource to appointment call center department.
Works and assists with the billing department in researching and resolving rejected, incorrectly paid, and denied claims as requested.
Responds professionally to all inquiries from patients, staff, and payors in a timely manner.