Medical Insurance Verification Specialist

ORTHOPAEDIC ASSOCIATES OF WISCONSIN•Village of Pewaukee, WI

1d•Hybrid

About The Position

For over 40 years, Orthopaedic Associates of Wisconsin (OAW) has been the state’s premier orthopedic practice, delivering exceptional care through innovation and expertise. Our team includes highly skilled orthopedic surgeons and dedicated health professionals—all working together at the forefront of surgical advancements, rehabilitation, and patient education. We believe that investing in our staff leads to better patient outcomes. At OAW, there is a difference. The Insurance Verification Specialist is responsible for ensuring insurance coverages are verified via insurance portals or phone. This includes working all internal emails sent showing insurance rejections, updating Epic with new/correct coverage, noting accounts and responding via email of completion of verification. Maintains high quality customer service standards in compliance with federal and state guidelines. Will perform other duties as assigned by management.

Requirements

High School Diploma or equivalent
Three or more years of experience in healthcare billing.
Experience using EPIC, Microsoft Office, and Payer Portal.
Must be able to maintain a professional attitude and confidentiality.
Strong oral, written communication, and time management skills
Ability to work in a team environment
Ability to multitask in a high volume, fast paced working environment.

Nice To Haves

Familiarity with commercial insurance guidelines and medical terminology
Background in healthcare is a plus!

Responsibilities

Use of payer websites or outbound calls to payers to verify the patient insurance coverage and identify available benefits.
Contact insured patients or other involved parties to obtain missing information.
Identify any payer coverage restrictions such as out of network and/or coverage with no out of network benefits.
Communicate case details to appropriate internal parties once benefit verification is complete.
Accurate and efficiently enter data of patient information and insurance details.
Accurately documents insurance findings in patient account notes.
Communicate with patients calling to make payments on account and processing of payments through credit card payment portal.
Effectively multitask in a high volume, fast paced environment.
Ability to work and contribute independently.
Effectively meets time completion goals.
Participate in and complete special projects and perform additional duties as required.
Maintains high quality customer service standards in compliance with federal and state guidelines.