Medical Insurance Verification Specialist

The Eye Institute

Position: Insurance Verification Specialist

Position Type: Full-time

Location: Tulsa, OK

About us: The Eye Institute has been providing the highest quality of eye care in an ever-changing world of medical innovation. Today, we're known as Northeast Oklahoma’s most comprehensive eye care centers. The Eye Institute is a multi-specialist Ophthalmology practice, offering services ranging from comprehensive eye exams to specialty services including General Ophthalmology, Cornea, Retina, Glaucoma, Pediatrics and Adult Strabismus, Refractive and Oculoplastic and Orbital Surgery.

About the position:

The Insurance Verification Specialist is responsible for verifying patient insurance eligibility, benefits, obtaining authorizations prior to appointments, and ensuring all required insurance information is accurate before patient appointments and procedures.

Essential functions:

• Verify specialist copays, deductibles, coinsurance, and out of pocket maximums.
• Determine patient financial responsibility.
• Identify coverage limitations and exclusions.
• Verify routine vision versus medical eye care benefits when applicable.
• Determine if referrals or prior authorizations are required
• Obtain and track referrals from primary care physicians
• Submit authorization requests to insurance carriers.
• Monitor authorization status and follow up as needed.
• Ensure approvals are received prior to services being rendered.
• Document authorization numbers and expiration dates.

Knowledge, skills, abilities required for the position:

• Knowledge of Medicare, Medicaid, Commercial Plans, VA and Indian Health plans
• Experience using payer portals and insurance verification systems
• Understanding of prior authorization processes and insurance guidelines.
• Strong attention to detail and organizational skills.
• Excellent customer service skills.
• Knowledge of grammar, spelling and punctuation.
• Skill in operating a variety of office equipment.
• Ability to establish and maintain effective working relationships with other employees and the public.
• Ability to read, interpret, and apply policies and procedures.
• Ability to identify problems, recommend solutions, organize and analyze information.
• Knowledge of medical practice procedures and functions preferred

Physical/Mental requirements:

· Requires good physical and mental health.

· Requires full range of body motion including lifting and carrying of patient charts, manual and finger dexterity and eye-hand coordination.

· Requires standing, walking and sitting for extensive periods of time

· Requires corrected vision and hearing to normal range.

· Requires the ability to communicate clearly and effectively, verbally and orally.

· Requires working under stressful conditions or working irregular hours.

· Requires a professional attitude to deal with patients with an unpleasant aspect of illness.

Required experience:

• High school or equivalent, preferred.
• Minimum of 1 year experience in insurance verification, medical billing, or healthcare administration preferred
• Ophthalmology or specialty practice experience preferred.

Benefits:

· Health Insurance

· Dental Insurance

· Vision Insurance

· 401k w/ company match

· Profit Sharing Plan

· Optional Insurance plans including: Term Life, Long-Term Disability, Accident, Cancer, FSA, Critical Illness.

· 6 days paid Personal time per year

· 10 days paid Vacation per year

The Eye Institute, Inc. is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and pregnancy-related conditions), gender identity or expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, genetic information, Equal opportunity extends to all aspects of the employment relationship including but not limited to hiring, promotions, training, working conditions, compensation, benefits, discipline and discharge, or any other characteristic protected by applicable federal, state or local laws and ordinances.

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan

Work Location: In person