Insurance Specialist Jobs

About The Position

Requirements

• High school graduate or equivalent.
• Customer service and organizational skills.
• Data entry experience and good phone etiquette.
• Knowledge of database management and ability to problem-solve.

Nice To Haves

• At least one year of healthcare office experience.
• Experience with medical terminology, medical coding, billing procedures, and medical records.
• Basic knowledge of payor guidelines.

Responsibilities

• Verify insurance eligibility and authorizations, carry out payor requirements, initiate eligibility transactions to obtain billing information and authorization, and arrange referrals when appropriate.
• Obtain and understand clinical information, including diagnoses, to initiate authorization requests.
• Ensure the correct insurance, plan type, financial obligations, precertification, and billing address are entered in the system.
• Communicate and update medical-record information about patients’ financial obligations for therapy sites, clinicians, and the billing office, including copayments, deductibles, self-pay rates, in- and out-of-network responsibilities, referrals, and authorizations.
• Respond to patient questions about financial liability, explain relevant variables, help address issues or barriers, and direct patients to appropriate financial counseling resources when needed.
• Collaborate with the business office, clinical teams, and patients on denials and appeals as necessary.
• Communicate with system departments, including managed care, SBO, and FCC, to identify changes, trends, or updates to existing or new insurance contracts.
• Back up other administrative functions as needed, including patient registration and scheduling, front desk operations, answering phones, collecting copayments, and tracking plans of care.
• Perform other duties as assigned.
• Travel between outpatient sites as assigned based on coverage needs.