Description

The Insurance Verification Specialist is responsible for performing all activities related to third party payer pre-certification functions for Women’s Care services.

• Contact insurance companies via telephone and/or insurance websites for eligibility, eligibility dates, deductible, co-payments, and co-insurance amounts due.
• Verify eligibility and benefits prior to patient’s scheduled appointments or procedures.
• Document all necessary information in appropriate systems.
• Determine provider participation status with payer.
• Answer incoming billing customer service phone calls and emails.
• Demonstrate and embody the Women’s Care mission and core values.
• Compliance with all HIPAA rules, regulations, and guidelines.
• Other duties as assigned.

Qualifications

• High school diploma or equivalent required.
• A minimum of 1-2 years’ medical billing/insurance verification experience.
• Solid working knowledge of HMO’s, PPO’s, Medicare, Medicaid, PAC, Commercial, Worker’s Comp, and liability insurances.
• Ability to interact with patients, families, staff, management, physicians, insurance representatives, and other third-party payers.
• Knowledge of CPT, ICD-10, and medical terminology.
• Excellent customer service skills, both verbal and written.
• Proficiency in all Microsoft Office programs.
• Must be highly detail-oriented and organized.
• Able to handle stressful situations tactfully.
• Demonstrate excellent problem-solving skills.
• Ability to work in a fast-paced, ever-changing environment.
• Dependable, reliable, and punctual.