Job Summary

The Insurance and Benefits Specialist is responsible for verifying health insurance eligibility and benefits for all new patients and existing patients. This position will contact patient’s insurance companies via phone and/or insurance portals to verify active coverage, deductible information, co-insurance information, applicable copays, physician’s participation with plan, and necessity of authorizations for multiple procedures.

Job Responsibilities:

· Verify patient insurance coverage.

· Verify in-network and out-of-network deductibles, co-insurance, and copays.

· Verify participation with patient’s plans for individual physicians.

· Notify patients and help arrange alternative payment methods when coverage does not cover services.

· Update patient benefits information in EMR.

· Perform routine administrative and clerical tasks.

· Consistently review eligibility via phone and/or insurance portals.

· Request payments from patients and guarantors where appropriate.

· Assist Supervisor/Manager with related job tasks.

· Assists with training support of new hires.

Job Qualifications:

· A minimum of 2 years experience in insurance and benefits verification.

· A minimum of 1 year experience in physician billing.

· Candidate must demonstrate working knowledge of contracts, insurance benefits, exclusions and other billing requirements as well as claims forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations.

· Functional proficiency in compute software skills (e.g., Word, Excel, E-mail, etc.)

· Must have experience with electronic billing systems.

· Must demonstrate effective communication skills

· Knowledge of medical terminology is a must.

· Knowledge of MacPractice is a plus but not required.

· Knowledge of Mac based computers and/or Mac based billing software a plus but not required.

· Medical billing and coding experience a plus but not required.

Job Type: Full-time

Pay: $40,000.00 - $50,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday
• No weekends

Experience:

• Insurance verification: 2 years (Preferred)
• Epic: 1 year (Required)

Work Location: In person