Insurance Verification Specialist

Responsibilities

• Responsible for verifying patient medical insurance eligibility through phone & online access of private insurance companies.
• Update insurance information for existing patients
• Collect updated insurance information from patients when necessary
• Inform relevant clinical staff about denials and coordinate with procedure scheduling
• Answer questions related to billing and insurance
• Analyze billing activities and address insurance claim denials or non payment with billing partner
• Handle billing and claim inquiries

• Determines insurance benefit compatibility for Clinical, ASC surgery and Pain management.
• Coordinates with patients regarding their insurance benefits and procedures, re-verifying existing patient insurance coverage, and determining if an insurance benefit plan considers selected products appropriate based on patient need.
• Obtains pre-certification or authorization for procedures and enters into billing system software.
• Completes data entry and or appropriate forms to document patient's benefits coverage.
• Alerts the Front Desk staff / PAC/PAR about uninsured or underinsured patients.
• Supports leadership with daily, weekly monthly reporting needs as required
• All other duties as assigned

Requirements and Qualifications

• High school diploma or GED certificate
• Medical billing experience (2 years preferred)
• Personal Injury experience is preferred
• Knowledge of CPT codes and basic medical terminology (preferred)
• Knowledge of ICD-10, CPT, HCPCS and the use of modifiers preferred.
• Knowledge of physician billing and/or collections.
• Phone communication skills