Insurance Verification Specialist - Office/hybrid role

Edwards Health Care Services, Inc.•Morehead City, NC

12d•Hybrid

About The Position

GEMCORE’s continued success has earned us national recognition with Inc. Magazine’s list of America’s Fastest-Growing Companies and with the Cleveland Plain Dealer as a Top Workplace six years running! We are looking for qualified candidates who share our enthusiasm and drive for winning and want to be part of our caring culture! Are you looking to begin or further your career in the medical supply industry where you are able to contribute to the success of the business, and build lasting relationships? All while allowing for personal time every evening, weekend, and holiday? Edwards Health Care Services (EHCS), a division of GEMCORE, is a well-established and growing national direct-to home medical supply provider. We are seeking a highly motivated Diabetes Care Insurance Verification Specialist to join our high energy team. The Diabetes Care Advisor’s primary role is to serve as the main point of contact for each patient and coordinate their health care professional, insurance benefits insulin pump and continuous glucose (CGM) orders with physician offices and insurances, ensuring excellent customer service throughout entire from start to finish. This role will effectively communicate via telephone and email with customers and patients; an outgoing personality and eye for detail is vital. This is a full-time, non-exempt, entry level position. This position is located in Morehead City, NC. This position would be a hybrid office/work from home position after training is complete. Schedule is 8:15 am - 5:00 pm, Monday through Friday. Employer paid vacation. Benefits available included medical/dental/vision, life, short and long-term disability insurances, and 401K Retirement Savings Plan. Ongoing training and development.

Requirements

Self-starter with the ability to work independently to achieve desired results.
Good organizational and multitasking ability required.
Excellent telephone and proficient computer skills required.
Minimum of 1-2 years of experience in a consumer service organization or healthcare environment.
Demonstrated problem solving skills.
Light lifting of up to 25 pounds.
High School Diploma or GED Equivalent

Nice To Haves

Clinical background helpful but not necessary.

Responsibilities

Verify customer insurance and process change of insurance task/updating account.
Data entry of updated customer account information for claim processing.
Be knowledgeable of company products, Medicare guidelines, and various types of insurance plans to determine customer eligibility.
Develop and maintain positive relationships with medical offices, insurance companies, federal and state agencies.
Direct customer communications when necessary to determine third party reimbursement.
Analyze healthcare provider guidelines to resolve benefit plan and coverage discrepancies.
Escalate discrepancies when necessary and understand when to “bump –it –up” to the management level.
Troubleshoot insurance coverage issues for new and existing customers.
Process and ship customers change of insurance orders.