Insurance Verification Specialist

Bluebird Kids Health•West Palm Beach, FL

6d•Hybrid

About The Position

About Bluebird Kids Health Bluebird Kids Health is a dynamic organization that provides underserved communities with new access to value-based pediatric primary care. We are on a mission to provide exceptional care, so every child can thrive. We offer comprehensive, evidence-based primary and urgent care services to children and their families, with support around-the-clock. Our care model includes robust care coordination, chronic disease management, and other population health supports. Our success is measured by exceptional health outcomes, lower medical costs, an outstanding child and family experience, and a rewarding environment for our clinicians and teams.

Requirements

High school diploma or equivalent with excellent computer skills
Insurance verification, medical billing, or other relevant healthcare practice experience required
Knowledge of basic health insurance terminology.
Knowledge of basic differences across payer types (e.g., Commercial insurance vs. Medicaid) and plan types (e.g., HMO vs. PPO products).
Knowledge of customer service principles and techniques.
Ability to work independently and as part of a team with a strong sense of focus.
Ability to communicate calmly and clearly with patients and payer representatives.
Ability to analyze situations and respond appropriately.

Nice To Haves

preference for primary care
Experience with Athena EHR System preferred

Responsibilities

Reviews insurance eligibility and coverage issues across practice sites for new and existing patient appointments three (3) days out (leveraging automated eligibility checks from our Electronic Health Record (EHR) system).
Reaches out to payers (e.g., via phone or payer portal) and communicates proactively with families to resolve insurance issues prior to a visit. Flag open issues for practice teams for follow-up on day of visit.
Serves as the primary escalation contact for the central operations scheduling team on pre-visit insurance and eligibility issues.
Serves as the main point of contact for practice-based teams (e.g., reception) on day-of-visit insurance eligibility questions.
Follows up post-visit on lingering primary care provider (PCP) assignment issues and Coordination of Benefits (COB) discrepancies with payers and patients/families.
Ensures pertinent information relating to patient insurance and eligibility is documented accurately in the EHR.
Works with front desk/reception staff to ensure appropriate collection of co-pay and self-pay fees based on verified benefits.
Uses customer service principles and techniques to deal with patients calmly and pleasantly and assist with insurance-related questions or issues.
Identifies trends in recurring eligibility, PCP assignment, or COB issues across sites and communicates them to leadership.
Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
Performs other duties as assigned