Insurance Verification

Description POSITION: Insurance Verification Specialist DEPARTMENT: Insurance Verification REPORTS TO: Insurance Verification Manager GENERAL DESCRIPTION Overall responsibility for ensuring that patient health care benefits cover required procedures.
This individual will contact the patient’s insurance company to verify coverage levels and works with individuals to educate them on their benefits information.
Additionally, this individual works to meet State and Federal Regulatory guidelines and complies with agency policies and procedures.
Ensures the duties are completed in a timely and proper manner.
Requirements ESSENTIAL DUTIES 1.
Insurance Verification Specialist is responsible for obtaining verification of patient payer benefits and eligibility.
This includes Private Insurance, Veteran’s, Medicare/Medicaid etc.
2.
Verify insurance information for new patients and referrals.
3.
Update insurance information for existing patients 4.
Call to obtain authorization for recommended services.
5.
Answer incoming verification calls for all sites.
6.
Inform relevant clinical/billing staff about denials.
7.
Provide accurate documentation of conversations regarding patients.
8.
Scan and attach insurance documents as needed for billing.
Authorizations etc.
9.
Secure patient information in accordance with policy/procedures.
10.
Answer phone calls, return missed calls check emails and voicemails daily.
11.
Acting as a resource to patients and communicating as appropriate with other family members involved in patient care regarding insurance coverage.
Maintains professional positive and effective communication with payers, patients, and colleagues.
12.
Other duties as assigned.
QUALIFICATIONS AND SKILLS 1.
High school diploma or equivalent.
2.
One year experience in a medical office, hospital, outpatient clinic, or other health care setting preferred.
3.
Knowledge of insurance process and medical terminology preferred.
4.
Ability to multi-task, detail oriented, organized ability to maintain accurate records, work quickly to process items in a timely manner, work well with others.
Excellent phone skills with an emphasis on customer service Computer literacy Intermediate typing skills Organizational skills