What are the responsibilities and job description for the Insurance Verification Specialist position at South Heart Clinic?
Job Title: Insurance Verification Specialist
Department: Billing
Position Summary: Responsible for insurance verification, precertification and preauthorizations.
Duties And Responsibilities Include But Are Not Limited To
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Department: Billing
Position Summary: Responsible for insurance verification, precertification and preauthorizations.
Duties And Responsibilities Include But Are Not Limited To
- Assists with the verification of insurance benefits, eligibility, co-pay and deductibles.
- Precertification/preauthorization of indicated studies.
- Ensures that all precertifications/preauthorizations are done in advance, before the patient is scheduled for the studies indicated.
- Submits required notes to the insurance carriers for authorization purposes.
- Ensures documents (authorization/data/numbers are entered into EHR system appropriately.
- Communicates with the physicians and nursing supervisor with non supportive documentation.
- Reviews account information and identify patient balances, flags account for the reception desk and collection department.
- Communicates with all carriers: Medicare, Medicaid, Commercial, PPO, Network benefits, etc.
- Seeks advice and guidance from certified coder with regards to coding guidelines and any questions.
- Greets patients and visitors in a prompt, courteous, and helpful manner. Checks in patients, verifies and updates necessary information in the patients EMR.
- Enters all of patient information into the medical billing system.
- Maintains appointment schedule and follows office scheduling policies.
- Communicates with patient and providers.
- Scheduling, canceling, and rescheduling patient appointments.
- Reminding patients of upcoming appointments and tracking missed appointments. Answering multiple telephones and accurately documenting messages.
- Forwarding telephone calls appropriately and following up on return calls.
- Checking-in patients and properly documenting registration.
- Collecting co-pays and cash from patients, getting authorization on credit cards.
- Maintains work area and lobby in neat and orderly manner.
- Practice and adhere to HIPPA regulations.
- Education-High School Diploma some college preferred.
- Knowledge of basic office procedures.
- Knowledge of basic office equipment including copier, fax machine, and computer.
- Ability to speak clearly concisely.
- Skills in dealing with interpersonal issues and patient relations.
- Ability to handle multiple priorities at once with minimal supervision.
- Knowledge of medical terminology.
- Ability to maintain confidentiality of patient information.
- Understand the mission and vision of the clinic.
- Operate within the concept of patient focused care.
- Evolve into an effective team member.
- Maintain good grooming and personal hygiene habits.
- Adhere to attendance policies.
- Conform to employee policies and office procedures.
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