Insurance Verification Specialist

Kennedy Krieger Institute•Baltimore, MD

1d•$40,043 - $66,205

About The Position

The Insurance Verification Specialist I (IVS I) obtains, clarifies, and confirms outpatient benefits to support maximum and prompt payment for services rendered. The role provides customer service to patients and families, health insurance representatives, internal and external providers, clinics, and other Institute staff. It also gathers and enters patient information, coordinates referrals and authorizations, estimates self-pay portions, and communicates pending issues to applicable parties.

Requirements

High school diploma or GED required.
At least 1 year of related experience with insurance benefit verification in a healthcare setting required.

Nice To Haves

Associate degree desirable.
2–3 years of EPIC experience preferred.

Responsibilities

Verify insurance coverage and benefits using available verification and eligibility tools, contacting payers when needed, and document findings in the registration system.
Verify or obtain required referrals, authorizations, or pre-certifications before services are provided, as required by the payer.
Obtain patient information to verify unique patient identifiers for clinical purposes, billing and collections, and compliance with state and federal regulations.
Estimate patient self-pay portions after benefits are determined, including deductibles, co-pays, and non-covered services.
Document and follow up on efforts to promote team and clinic awareness.
Collect current demographic information from patients and families.
Communicate and follow up regularly with patients, families, and KKI programs and departments, including team leaders, Patient Accounting, and Finance; keep applicable parties informed of pending referrals, authorizations, delays, and potential issues.
Forward supporting documentation promptly to Care Centers, Patient Accounting, and clinical areas when applicable.
Maintain browser and IAMS Error Logs accurately and promptly.
Accurately and completely capture and enter patient demographic, financial, and clinical information into applicable information systems, including pre-registration and scanning systems.