Overview

Insurance Verification Specialist

Summary: The Insurance Verification Specialist requires specific knowledge of health insurance plans, interpretation of benefits, and prior authorization protocol. Also, general knowledge of data management, medical practice workflow, and related activity. This job involves providing administrative assistance to the clinical and billing teams.

• Paid Training
• Health, Dental, Vision, and Life Insurance as well as Paid Time Off and Paid Holidays! 

Location: Clearwater, FL [Highpoint, ICOT]

Hours: Monday - Friday, 8:00AM-5:00PM

Responsibilities

Essential Duties and Responsibilities:

• Eligibility: effectively and accurately verify active health insurance information and interpretation of benefits prior to service being rendered.
• Eligibility: effectively identify if patients have a Medicare or Medicaid advantage plan or replacement plan and locate the correct plan information.
• Eligibility: effectively and accurately verify that all patients’ insurance plans are active, and the patients are not listed on the death match file, post date of service.
• Eligibility: Effectively and accurately utilize the payer websites to verify insurance eligibility, such as: SPOT, Medicaid, Availity, UHC, and other payer websites.
• Account Maintenance: effectively and accurately create and maintain patient account information using face sheet and/or other data provided by servicing facilities.
• Document Management: effectively and accurately scan and index health records including but not limited to: face sheets, progress notes, insurance verification forms, insurance cards.
• Willingness to learn and apply health service concepts as they relate to interactions with persons served.
• Ability to communicate in a clear and effective manner, both orally and in writing.
• Ability or willingness to learn, willingness to acquire functional knowledge of software as needed.
• Skill in clerical work: typing, data compilation, filing and including overall attention to detail and follow through.
• Ability to maintain confidentiality.
• Provide telephone and department support, as needed.
• Performs other related clerical duties, as assigned.

Supervisory Responsibilities:

None

Qualifications

Qualifications:

• Understanding and effective use of basic principles of administration in a healthcare environment.
• Experience in using electronic health record software, insurance eligibility and electronic billing.
• Strong computer skills in including proficiency using EHR, SPOT, Availity, Navinet and other payer sites.
• Exceptional communication skills - both written and verbal.
• Ability to read, understand, and adhere to CMS guidelines and compliance.
• Superior organizational skill, attention to detail, ability to work without micro-management.

Education and/or Experience:

• Minimum Experience Required - One year in insurance verification.

Certificates, Licenses, Registrations: 

None

Computer Skills:

•  Proficiency using software programs such as MS Word, ACCESS, PowerPoint, Excel and Outlook 

Environmental Factors/Physical Demands:

Work is performed in an office environment. While performing the duties of this job, the employee is regularly required to have the ability to maintain active customer and employee communication; access, input and retrieve information from the computer system; enter alpha-numeric data into a computerized system often while listening on the telephone. May be subject to repetitive motion such as typing, data entry and vision to monitor. May be subject to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds.

KG123