Insurance Verification Specialist

Shriners Hospitals for Children•Tampa, FL

12h•Onsite

About The Position

Under the leadership of the Billing and Contracts Manager, the POPS Insurance Verification Specialist is an active member of the O&P Billing Team who delivers support that is consistent with the strategic vision, goals, philosophy and direction of Shriners Children's organization and POPS (Pediatric Orthotic and Prosthetic Services). The Specialist is responsible for determining the status of a patient’s insurance eligibility/coverage by contacting the appropriate insurance or third party payor in accordance with POPS policies and procedures. The Specialist will have a thorough knowledge and understanding of Commercial, Managed Care, Medicaid, Managed Medicaid and Medicare payor guidelines and eligibility criteria. The Patient Insurance Specialist will physically be located remotely, but perform insurance verification for assigned hospitals located throughout the country. This is a 100% onsite position at our Corporate Headquarters in Tampa, FL.

Requirements

3 Years Insurance prior-authorization in a medical office and/or hospital setting
MS Office Suite
High School Diploma/GED

Nice To Haves

Durable Medical Equipment experience

Responsibilities

Updates OPIE with the appropriate eligibility and COB status.
Documents in the health plan comment field on the encounter all actions that have been taken on the account related to insurance verification and authorization
Updates health plans as needed based on feedback from the insurance company.
Maintain a detailed level of knowledge of all payors authorization/referral guidelines and update all appropriate fields in OPIE.
Maintains a productivity log on a daily basis
Coordinates and prioritizes assigned activities to achieve maximum productivity
Completes special projects as directed by the Manager of Patient Access.
Responds positively to necessary changes in the workplace
Attend workshops and seminars, read manuals and updates to maintain a high level of knowledge of all payor criteria
Maintains professional competency, according to department policies, procedures and protocols