Insurance Verification Specialist

Be part of an AMAZING team!!!

The Buckingham is the premier not for profit, Life Care retirement community in the greater Houston region. Our mission is to enrich each resident’s life through exceptional experiences provided within an environment of comfort, elegance, exceptional hospitality and compassionate care. We offer a competitive salary and benefits including medical, dental and vision coverage, 401k with match, PTO, tuition reimbursement and meal programs. We are seeking an experienced professional with the skills, dedication and compassion to join our team and help achieve the mission and vision of The Buckingham.

POSITION SUMMARY

The primary function of the Insurance Verification Specialist is to contact carrier groups to obtain eligibility information, ensuring that the most updated verification is entered into the practice management software. Develops and maintains effective relationships with the patients ensuring all patient demographic and insurance information is obtained.

REQUIRED EDUCATION/EXPERIENCE

High school diploma or GED equivalent; customer service; must be computer literate; have multi-tasking skills, excellent organizational skills, verbal and written communication skills; team player.

POSITION RELATIONSHIPS

Reports directly to the Business Office Director

Subject to a 90-day probationary period

Two weeks’ notice required for resignation 

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Responsible for effective and efficient verification of all patients’ benefits before admission.
• Responsible for answering incoming calls from other providers, recipients, and carrier groups in relation to insurance coverage.
• Research eligibility information online with various insurance carriers.
• Responsible for acting as a liaison between patients, healthcare providers, and insurance carriers to ensure all proper measures are taken and information is collected.
• Responsible for obtaining all referrals and authorizations for procedures and services, as required.
• Responsible for communicating with patient pre-admission for explanation of benefits and patient financial responsibilities.
• Provides timely communication to the Business Office Director and Healthcare Administrator on any payor concerns prior to admission.
• Responsible for communicating with patient post admission to clarify of benefits and patient financial responsibilities within community policy timeline
• Ensures all patient questions are answered and issues are resolved timely by utilizing the appropriate resources.
• Communicates with Business Office Director on all current patient financial concerns with regards to verification, benefits, and/or payment. 
• Serves as back up to the Admission Coordinator
• Other duties as assigned by the Business Office Director.

PROFESSIONAL

• Treat all patients and staff with compassion and empathy.
• Adapt communication to an individual’s ability to understand.
• Use medical terminology appropriately.
• Respond to communications received within a reasonable time frame.
• Project a professional manner and image.
• Adhere to ethical principles.
• Demonstrate initiative and responsibility.
• Work as a team member.
• Manage time efficiently
• Prioritize and perform multiple tasks.
• Adapt to change, including new hours of operation and methodology.
• Attends all assigned staff meetings and mandatory in-service education.
• Maintain proper observation and adherence to company policies and procedures, including the Employee Handbook.

KNOWLEDGE, SKILLS, AND EXPERIENCE

• Good organizational skills and the ability to multi-task
• Ability to operate basic office equipment, answer multi-line telephones, and have a strong computer background.
• Establish and maintain effective working relationships with patients, insurance companies, and staff.
• Good written and oral communications.
• Knowledge and skills in working with computerized billing systems including practice management software and EMR.
• Must adhere to all HIPAA guidelines and regulations.
• Knowledge of medical insurance and authorization processes.
• Some medical terminology and experience working in a healthcare or insurance environment. 

LEGAL

• Maintain patient and company confidentiality.
• Practice within the scope of education, training, and personal capabilities.
• Document company documents (hard copy and electronic) accurately.
• Use appropriate guidelines for releasing information.
• Maintain awareness of federal and state health care legislation and regulations; OSHA, CLIA, and HIPAA.

ENVIRONMENTAL ADAPTABILITY

• Works primarily indoors in a climate controlled setting
• Possible exposure to unpleasant odors
• Possible exposure to chemicals as identified in the MSDS Manual
• Continuous exposure to residents who are ill, confused, irritable and irrational

PHYSICAL REQUIREMENTS

The physical demands described below are representative of those that must be met by an individual to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the Team Member is regularly required to use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The Team Member is frequently required to stand; walk and stoop, kneel, crouch, or crawl. The Team Member is occasionally required to sit; climb or balance.  The Team Member must regularly lift and /or move up to 10 pounds, frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds.  Specific vision abilities required by this job include close vision and distance vision.