Insurance Verification Specialist: Patient Accounting

Hoag • Costa Mesa, CA

4h

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.

Responsibilities

• Verifies insurance and benefit coverage for services
• Works directly with patients, insurance companies, and clinical departments to verify insurance coverage and obtain 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, 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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed