Insurance Verification Specialist

Women's Care•Jacksonville, FL

19h

About The Position

The Insurance Verification Specialist performs activities related to third-party payer pre-certification for Women’s Care services. The role contacts insurance companies by telephone or through insurer websites to confirm eligibility and eligibility dates, deductibles, co-payments, and co-insurance amounts due. The specialist verifies eligibility and benefits before scheduled patient appointments or procedures, documents relevant information in appropriate systems, and determines provider participation status with payers. The position also responds to incoming billing customer service calls and emails, complies with HIPAA rules and guidelines, embodies Women’s Care’s mission and core values, and performs other duties as assigned.

Requirements

High school diploma or equivalent required.
At least 1–2 years of medical billing or insurance verification experience.
Solid working knowledge of HMO, PPO, Medicare, Medicaid, PAC, commercial, workers’ compensation, and liability insurance.
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 verbal and written customer service skills.
Proficiency in Microsoft Office programs.
Highly detail-oriented and organized.
Ability to handle stressful situations tactfully.
Excellent problem-solving skills.
Ability to work in a fast-paced, ever-changing environment.
Dependable, reliable, and punctual.

Responsibilities

Perform third-party payer pre-certification activities for Women’s Care services.
Contact insurance companies by telephone or through insurance websites to verify eligibility, eligibility dates, deductibles, co-payments, and co-insurance amounts due.
Verify patient eligibility and benefits before scheduled appointments or procedures.
Document necessary information in appropriate systems.
Determine provider participation status with payers.
Answer incoming billing customer service phone calls and emails.
Demonstrate and embody the Women’s Care mission and core values.
Comply with HIPAA rules, regulations, and guidelines.
Perform other duties as assigned.