Insurance Verification Specialist

Job Summary: In accordance with the organization’s mission, vision and values, 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 other in a team environment. The following duties will apply:

Duties

• Maintains patient demographic information in eCR.
• Verify insurance eligibility for admitted clients by utilizing online websites or by contacting the carriers directly.
• Review patient deductibles and/or copays and enter into the billing system and spreadsheets.
• Coordinate with front end regarding needed authorizations and those that are Medicaid Restricted.
• Assist front end staff and call center staff in understanding carrier websites and verification of eligibility.
• Enter insurance referrals as needed.
• Participates in development of organization procedures and update of forms and manuals.
• Answers questions from patients, clerical staff and insurance companies.
• Works in conjunction with billing to ensure accuracy of claims.
• 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.

Minimum Qualifications:

• Preferred experience doing prior insurance verification in a medical office. Minimum of 1 year of relevant experience and/or training, or equivalent combination of education and experience.
• Strong knowledge of administrative and clerical procedures.
• Ability to collaborate across departments and build effective relationships with internal and external customers to achieve goals.
• Knowledge of customer service principles and practices.
• Ability to achieve team goals while demonstrating organizational values and utilizing resources responsibly.
• Ability to be proactive and take initiative.
• 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. Other Skills/Knowledge and Experience
• Ability to work independently on assigned tasks, as well as to accept direction on given assignments.
• Proficient in computers and relevant software applications.
• Strong problem solving skills and sound judgement.