Insurance Verification Specialist and Patient Service Representative (PSR)

Description

Position Summary:

The Verification of Insurance (VOI) Specialist plays an essential role in supporting our team by verifying benefits, securing authorizations, and assisting with administrative tasks to ensure a smooth and positive patient experience. This is a full-time, non-clinical position based in Columbia, TN.

Responsibilities:

• Verify benefits and obtain authorizations if needed.
• Cross-train and assist at the front desk, including:
  • Scheduling appointments
  • Assisting with patient check-in/out
  • Completing reports (e.g. task preregistration completion)
  • Collecting account payments and copays
• Communicate professionally with patients (in person and by phone) and team members to support excellent customer service.
• Demonstrate working knowledge of:
  • Electronic documentation systems
  • Microsoft Office Suite
• Place phone calls to patients, patient’s family/significant other, insurance companies, and facility personnel in an attempt to acquire information necessary to verify.
• Responsible for resolving any issues with coverage, referrals, precertification and escalate complicated issues to the immediate manager. Also, must have a basic knowledge and understanding of what a referral and an authorization are.
• Enters and ensures information in the insurance fields is correct to its entirety. If incorrect, information in the system must be updated appropriately. This includes moving any VOB’S, authorizations and clinical referrals. If encounters were billed incorrectly to a now corrected insurance, you must email collections so claims can be rebilled if needed.
• Familiar with a variety of the facility concepts, practices, and procedures. Relies on experience and judgment to plan and accomplish goals.

Requirements

• Prior experience collecting copays, deductibles, coinsurance, and outstanding balances.
• Knowledge of insurance processes, terminology, and workflows.
• Experience reading and interpreting payer eligibility electronic returns, including the ability to differentiate between insurance plans, copay, deductible, and coinsurance (patient responsibility).
• Familiarity with administrative and clerical processes.
• Strong communication skills, professional demeanor, and commitment to excellent customer service.
• Proficient in Microsoft Office Suite and comfortable learning new electronic systems.

Preferred Qualifications:

• Experience using NextGen software.

Benefits:

• Competitive pay
• Comprehensive benefits package including medical, dental, and vision coverage
• 401(k) with employee match and discretionary profit-sharing
• Paid Time Off (increases with years of service)
• Paid holidays

TOA is an equal opportunity employer. TOA conducts background checks and drug screens on applicants who accept employment offers. TOA adheres to HIPAA and OSHA safety guidelines.