Insurance Verifier

Surgery Partners•Los Angeles, CA

About The Position

The Insurance Verification Specialist is responsible for verifying assigned patient insurance benefits in a timely manner while maintaining satisfaction among patients, referring physicians, and insurance companies. The role reports to the Billing Manager and performs insurance verification, authorization, patient-account documentation, and related support duties in a busy office environment.

Requirements

High school education.
1–2 years of experience in healthcare insurance billing and verification, collections, and/or authorizations.
Knowledge of clinic policies and procedures.
Knowledge of managed care contracts and utilization.
Knowledge of computer systems, programs, and spreadsheet applications.
Knowledge of medical terminology.
Knowledge of CPT/ICD-9.
Skill in gathering and reporting claim information.
Skill in solving utilization problems.
Written and verbal communication and customer-relations skills.
Ability to work effectively with medical staff and external agencies.
Ability to identify, analyze, and solve problems.

Responsibilities

Maintain records with integrity and in compliance with applicable regulations and requirements.
Obtain required referrals and authorizations by phone, fax, online, or other methods.
Review daily reports for patients requiring authorizations, pre-notification, or insurance benefit verification.
Obtain retroactive authorizations or update existing authorizations in a timely manner.
Perform accurate data entry in a fast-paced environment.
Update patient accounts with insurance verification details.
Coordinate with patients regarding their insurance benefits.
Identify deductibles, co-pays, and self-pay accounts.
Notify appropriate staff when treatment or services are denied.
Re-verify patients monthly to confirm active, current insurance.
Assist the manager and other staff with account questions.
Perform other duties as assigned.
Use experience and judgment to plan and accomplish goals.