RCM 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 others in a team environment. 

Essential Functions:

• Maintains patient demographic information and verifies, enters or updates insurance information for new patients and existing patients to include copays and deductibles 
• Verify insurance eligibility for upcoming appointments by utilizing EMR, online websites or by contacting the carriers directly.
• Explain financial responsibilities to patients.
• Coordinate with staff and management regarding scheduling errors. Update the error spreadsheet daily. 
• Enter insurance effective dates and/or authorization details.
• 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 the reception to ensure clean billing. 
• Performs miscellaneous job-related duties as assigned. 
• 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. 

Process:

• Check assigned locations daily and confirm eligibility, copay, and outstanding balance for every scheduled patient.
• Enter and update carrier details in the insurance section of the patient account to include plan name, effective dates, co-pays and deductibles.
• Flag and address potential errors. All errors should be logged onto the Eligibility Error Spreadsheet 
• Add copay and outstanding collection notes in the appointment details for the PSR to see and address during the check in process. 
• If further action is needed, due to portal downtime or insurance errors, enter notes into the appointment details for the PSR to see. 
• Maintain regular verification management at least two days ahead of schedule 
• Attempt to collect outstanding balances and/or work with RCM management to assist with questions 

Qualifications:

• Minimum of 1 year working in a medical office.
• Medical Billing experience preferred.
• Must be comfortable asking for payment.
• Must have outstanding phone etiquette and attention to detail. 

Benefits:

• Medical, Dental, Vision Coverage
• Life Insurance
• Paid Time Off
• Long Term Disability
• 401K Plan

Job Type: Full-time