Insurance Verification Specialist - RCM

Healthpro Heritage, LLC•Greenville, SC

20h•$18 - $20

About The Position

HealthPRO Pediatrics is hiring an RIV/Authorization Coordinator to join their Revenue Cycle team. In this role, the individual will verify patient insurance benefits, coordinate authorizations, and communicate with patients, therapy teams, and insurance representatives to ensure patients have appropriate coverage for therapy services. This position is ideal for someone with strong communication skills, attention to detail, and an interest in healthcare administration and revenue cycle operations.

Requirements

High school graduate or Equivalent
Ability to work in a team environment
Ability to read and interpret documents, medical records, and other related documentation
Ability to learn new processes and procedures quickly, handle a fast-paced environment, and prioritize tasks based on importance
Demonstrate excellent written and verbal communication skills
Sufficient typing skills, high level of proficiency with general office PC applications (i.e., MS Word, MS Excel), Medical Billing Software Systems, and comfort with learning new applications as required

Nice To Haves

Prior knowledge and experience with CPT and ICD-10 codes is strongly preferred.
1 – 2 years’ experience with medical insurance verification and authorization is a plus.

Responsibilities

Performs eligibility verification by entering ticket information into the Vendor system.
Obtains verification documents and uploads them appropriately in the EHR System.
Verifies insurance benefits via respective payer websites and calling insurances directly.
Ensures patient financial/consent to treat/HIPPA forms are signed and uploaded to the EHR.
Enters clear and concise comments in the EMR/RIV tickets regarding coverage dates and any policy limits, deductibles, and co-pays, etc.
Coordinates with providers to ensure all appropriate insurance documentation is uploaded for accurate benefit/eligibility checks.
Meets daily, weekly, and monthly productivity requirements.
Completes special projects as assigned by the Director of Revenue Cycle, RCM Manager and RIV Team Lead.