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Insurance Verification Specialist
ENT Associates Clearwater, FL
$37k-46k (estimate)
Full Time | Ambulatory Healthcare Services 2 Months Ago
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ENT Associates is Hiring an Insurance Verification Specialist Near Clearwater, FL

Position Summary: The Insurance Verification Specialist is responsible for the insurance verification of all insurance plans for Audiology, in office procedures and New and Established Office Patients. Insurance benefits and procedures are verified utilizing on-line insurance website resources or research which may require outbound phone calls to insurance companies. Once information is obtained, the Insurance Verification Specialist contacts the patient to educate them on their benefit information or obtain any demographic or insurance information required to verify the insurance. Once the insurance has been confirmed active, benefits are documented in the EMR. If the Insurance Verification Specialist is not able to obtain insurance information or patient is verified as self-pay/full fees benefits, the staff member is responsible for notifying patient via phone and documenting conversation in the EMR.
Reports to: Front Office Director
Flexibility: While the normal work week is 40 hours, you may be subject to overtime (not to exceed 50 hours per week).
Summary of General Duties:
  • Contact various insurance companies either by phone or on-line website to obtain insurance benefits.
  • Contact patient or PCP to obtain information necessary to verify insurance.
  • Verify insurance is accurate, updated and active.
  • Verify insurance eligibility and benefits for copay, deductible and coinsurance for:
    • Office visit, scope, allergy and audio.
    • Surgery procedures
    • Allergy services
  • Obtain referrals when necessary for new or established clinic patients. Includes faxing requests or calling the PCP office.
  • Scan faxed referral request and referral into EMR.
  • Obtains pre-certification/pre-authorization from insurance companies for:
    • Surgery procedures - done in either the operating room or clinic.
    • CT Scans
    • Speech Services
  • Confirms insurance are in-network. If not, then contact patient to discuss and make alternate arrangements as necessary per policy guidelines.
  • Communicates with the patient on their benefit information.
  • Document accounts in the EMR on the Registration Information Notes with benefit information or special instructions for Front Office.
  • Add insurance to EMR.
  • Update PCP and demographics in EMR.
  • Research enrollment issues due to lack of information or incorrect information.
  • Complete all task within the timelines established by the practice.
  • Answers the telephone in a warm, friendly manner.
  • Maintains patient confidentiality.
  • Perform other duties as assigned or requested.
  • Physical demands:
    • Average percent of time during regular shift devote to:
      • Walking, Squatting, Sitting, Bending, Reaching: 75%
      • Standing: 25%
    • Average lifting requirements:
      • Lifting Requirements: 20-40 lbs.
      • Frequency of Lifting: 0-25% of the time
    • Additional physical demands:
      • Ability to grasp with both hands; pinch with thumb or forefinger; turn with hand/arm; reach for (above shoulder height).
      • Ability to type 60 wpm.
      • Ability to operate multi-line telephone system, computer keyboard and ten-key adding machine.
  • Visual, Hearing, and Mental demands: Vision adequate to perform essential functions such as read telephone displays/computer terminals for long periods of time, correctable to 20/20. Hearing is adequate to perform essential functions such as answering the telephone. Mental capacity adequate to perform essential functions such as quickly and accurately entering patient demographics and scanning documents while checking in multiple patients. Tact to deal with unfriendly individuals regarding various situations, and adequately handle stress.
  • Working Conditions: This position has an option to work from home after training has been completed. Performance, reliability, and overall fit for the role will be assessed prior to an employee being given permission to work remotely and will continue to be assessed once the employee has gone remote. Required to exhibit a positive attitude and a professional appearance and show detail and accuracy. Required to exhibit quality performance of the essential job functions to help the practice run effectively and efficiently.
Position Requirements:
  • High School education or GED equivalent.
  • Minimum one year of medical office experience preferred.
  • Working knowledge of insurance verification process and contracted insurance plans.
  • Good verbal and written communication skills.
  • Excellent telephone and customer service skills.
  • Demonstrated ability to use a computer with Microsoft Word, Outlook and EMR software.
  • Strong organizational skills with the ability to multi-task.
  • The ability to attend work on a regular basis.
  • The ability to adhere to safety rules and other reasonable regulations pertaining to the job.
  • The ability to refrain from negativity or excessive irritability.
  • The ability to work in cooperation with other workers.
  • Ability to maintain confidentiality and thorough knowledge of HIPAA policies and procedures.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Ambulatory Healthcare Services

SALARY

$37k-46k (estimate)

POST DATE

04/14/2024

EXPIRATION DATE

07/09/2024

WEBSITE

ent-stl.com

HEADQUARTERS

CHESTERFIELD, MO

SIZE

100 - 200

TYPE

Private

CEO

DAVID P KRAJCOVIC MD

REVENUE

$50M - $200M

INDUSTRY

Ambulatory Healthcare Services

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