Medical Insurance Verification Specialist

Job Summary

We are seeking a proactive and detail-oriented Medical Insurance Verification Specialist to join our healthcare team. In this vital role, you will be responsible for verifying patient insurance coverage, obtaining prior authorizations, and ensuring accurate billing processes. Your expertise will help streamline patient care and facilitate smooth insurance interactions, contributing to efficient clinic operations. The ideal candidate will possess strong knowledge of health insurance policies, medical terminology, and electronic health records management, all while maintaining the highest standards of confidentiality and customer service.

Responsibilities

• Verify patient insurance coverage accurately by reviewing policies, benefits, and eligibility through electronic systems and direct communication with insurance providers.
• Obtain insurance prior authorization for procedures, treatments, or diagnostic tests to ensure coverage approval before service delivery.
• Maintain detailed records of insurance verification activities within Electronic Medical Records (EMR) or Electronic Health Records (EHR) systems.
• Communicate clearly with patients regarding their insurance benefits, coverage limitations, and required documentation to facilitate understanding and compliance.
• Collaborate with medical office staff to ensure billing codes (such as CPT coding) and diagnosis codes (ICD-9, ICD-10) are correctly applied for accurate claims submission.
• Stay updated on health insurance policies, managed care guidelines, and regulatory requirements such as HIPAA to ensure compliance.
• Support the medical office team by managing medical records requests and ensuring confidentiality in accordance with clinical confidentiality policies.

Requirements

• Proven experience in medical office administration or healthcare environment with a focus on insurance verification or billing.
• Strong knowledge of health insurance policies, managed care processes, and prior authorization procedures.
• Familiarity with medical coding systems including CPT coding, ICD-9, ICD-10, and ICD coding standards.
• Proficiency in Microsoft Office applications and EMR/EHR management systems.
• Excellent customer service skills with the ability to communicate complex information clearly and professionally.
• Understanding of HIPAA regulations and commitment to maintaining patient confidentiality at all times.
• Ability to multitask efficiently in a fast-paced healthcare setting while adhering to clinical confidentiality policies.

Join us in delivering exceptional healthcare experiences by ensuring seamless insurance verification processes! Our team values energetic professionals who are eager to contribute their expertise in a dynamic environment dedicated to patient care excellence.

Pay: $15.00 - $25.00 per hour

Benefits:

• 401(k)
• Paid time off

Work Location: In person

Salary : $15 - $25