Insurance Verification Specialist: Patient Accounting

Hoag•Costa Mesa, CA

5d•$24 - $34

About The Position

The Insurance Verification Specialist verifies insurance and benefit coverage for services in assigned department(s). This role works directly with patients, insurance companies, and clinical departments to verify insurance coverage, obtain proper authorizations, and ensure timely reimbursement of services. Reviews physician orders for medical necessity and accuracy and provides clinical documentation to support proper authorization. Accurately and timely codes insurance in the billing system. Provides patient education of service of benefits, status of pending or denied authorizations and gets assistance in resolving. Determines copayment and deductible amounts, maintains charge entry and reconciles daily charges. Accurately enters insurance benefit and authorization information into patient accounts. Seeks assistance as needed to maintain service levels. May arrange for peer-to-peer evaluations between physician offices and insurance companies as requested. Performs other duties as assigned.

Requirements

Ability to work directly with patients, insurance companies, and clinical departments.
Ability to verify insurance coverage and obtain proper authorizations.
Ability to ensure timely reimbursement of services.
Ability to review physician orders for medical necessity and accuracy.
Ability to provide clinical documentation to support proper authorization.
Ability to accurately and timely code insurance in the billing system.
Ability to provide patient education regarding benefits and authorization status.
Ability to determine copayment and deductible amounts.
Ability to maintain charge entry and reconcile daily charges.
Ability to accurately enter insurance benefit and authorization information into patient accounts.
Ability to seek assistance as needed to maintain service levels.
Ability to arrange for peer-to-peer evaluations between physician offices and insurance companies as requested.

Responsibilities

Verifies insurance and benefit coverage for services in assigned department(s).
Works directly with patients, insurance companies, and clinical departments to verify insurance coverage.
Obtains proper authorizations.
Ensures timely reimbursement of services.
Reviews physician orders for medical necessity and accuracy.
Provides clinical documentation to support proper authorization.
Accurately and timely codes insurance in the billing system.
Provides patient education of service of benefits and status of pending or denied authorizations.
Determines copayment and deductible amounts.
Maintains charge entry and reconciles daily charges.
Accurately enters insurance benefit and authorization information into patient accounts.
Seeks assistance as needed to maintain service levels.
May arrange for peer-to-peer evaluations between physician offices and insurance companies as requested.
Performs other duties as assigned.