Insurance Verification Specialist (73405)

Women's Care•Winter Park, FL

3d•Onsite

About The Position

The Insurance Verification Specialist is responsible for performing all activities related to third party payer pre-certification functions for Women’s Care services. This role involves contacting insurance companies via telephone and/or insurance websites to gather information on eligibility, eligibility dates, deductible, co-payments, and co-insurance amounts due. The specialist will verify eligibility and benefits prior to patient’s scheduled appointments or procedures, document all necessary information in appropriate systems, and determine provider participation status with payers. Additionally, the role includes answering incoming billing customer service phone calls and emails, demonstrating and embodying the Women’s Care mission and core values, and ensuring compliance with all HIPAA rules, regulations, and guidelines. Other duties as assigned.

Requirements

High school diploma or equivalent required.
A minimum of 1-2 years’ medical billing/insurance verification experience.
Solid working knowledge of HMO’s, PPO’s, Medicare, Medicaid, PAC, Commercial, Worker’s Comp, and liability insurances.
Ability to interact with patients, families, staff, management, physicians, insurance representatives, and other third-party payers.
Knowledge of CPT, ICD-10, and medical terminology.
Excellent customer service skills, both verbal and written.
Proficiency in all Microsoft Office programs.
Must be highly detail-oriented and organized.
Able to handle stressful situations tactfully.
Demonstrate excellent problem-solving skills.
Ability to work in a fast-paced, ever-changing environment.
Dependable, reliable, and punctual.

Responsibilities

Performing all activities related to third party payer pre-certification functions for Women’s Care services.
Contacting insurance companies via telephone and/or insurance websites for eligibility, eligibility dates, deductible, co-payments, and co-insurance amounts due.
Verify eligibility and benefits prior to patient’s scheduled appointments or procedures.
Document all necessary information in appropriate systems.
Determine provider participation status with payer.
Answer incoming billing customer service phone calls and emails.
Demonstrate and embody the Women’s Care mission and core values.
Compliance with all HIPAA rules, regulations, and guidelines.
Other duties as assigned.