Position: Revenue Cycle Specialist, Insurance Verification
Supervisor: Revenue Cycle Manager
Subordinates: None
FLSA: Non-Exempt
POSITION SUMMARY: The insurance verification specialist performs clerical functions for patient billing, including verification of insurance information and resolution of problems to ensure a clean billing process. Follows up on accounts that require further evaluation. Works with others in a team environment.
ESSENTIAL JOB DUTIES:
Maintains patient demographic informationand data collection systems.
Verify insurance eligibility for medical insurance for past and upcoming appointments by utilizing online websites or by contacting the carriers directly.
Coordinate with leadership regarding payer entry errors.
Assist front end and call center staff in understanding carrier websites and verification of eligibility.
Participates in development of organization procedures and update of forms and manuals.
Performs miscellaneous job-related duties as assigned.
Participates in educational activities and attends monthly staff meetings.
Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
Assists in development and communication of SOP for key areas to improve accuracy and understanding of processes.
QUALIFICATIONS & SKILLS:
Strong knowledge of administrative and clerical procedures.
Experience with computers, MicrosoftOffice suite and relevant software applications.
Possession of strong problem-solving skills and sound judgment.
Ability to collaborate across departments and build effective relationships with internal and external customers to achieve goals.Ability to achieve team goals while demonstrating organizational values and utilizing resources responsibly.
Ability to be proactive and take initiative.
Ability to work independently with little to no direction from leadership.
Exhibit high level of quality through attention to detail and monitoring of work.
Possession of strong organizational skills.
Excellent verbal and written communication, as well as exceptional interpersonal communication skills.
REQUIRED EDUCATION/DEGREE: High school diploma or equivalent; Bachelor’s degree in healthcare administration, business, billing and coding or related field preferred.
REQUIRED CERTIFICATION/LICENSE: Not applicable or required.
REQUIRED WORK EXPERIENCE: Prior Insurance Verification or Customer Service experience in a medical office.
Minimum of 1 year of relevant experience and/or training, or equivalent combination of education and experience.