Insurance Specialist III

Summary

The Insurance Specialist is responsible for accurately verifying primary and secondary insurance coverage of all cases and computation of case estimates.

Essential Duties and Responsibilities 

These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned. 

1. Fiscal Responsibilities

• Be proficient in determining appropriate co-payments/deductibles to ensure accurate patient financial responsibility, resulting in high collection rate 
• Remain knowledgeable of various insurance plans and be able to explain the benefits clearly to a patient 
• Verify patient benefits and communicate with insurance companies to receive authorization for payment 
• Accurately estimate service charges and patient self-pay responsibilities. 
• Be aware of the different opportunities available to patients for financial arrangements/programs. 

2. Data Entry 

• Demonstrate at least a 95% accuracy rate on all registrations 
• Remain versatile and be able to move patients in the computer system without difficulty 
• Ensure that spelling and content is appropriate and thorough
• Access patient's properly by using the correct medical record information 

3. Communication 

• Answer the telephone in a timely and professional manner with the appropriate greeting and identification protocols 
• Support co-workers in assisting with phones and be attentive and responsive to the needs of patients, physicians, and other customers 
• Have excellent language skills and be able to obtain information from patients in a professional, friendly manner. 
• Demonstrate sensitivity and tactfulness with patients and other customers 
• Ensure that documentation is clear, concise, and fully understandable 

4. Professional Development 

• Maintain a positive attitude towards all customers, whether internal and external, and management 
• Remain alert and enthusiastic in order to create a warm and friendly environment for patients. 
• Understand the importance of a first impression and strive to anticipate customer's needs 
• Work to improve the skills needed to identify and meet the customer's expectations in a climate of respect and professionalism
• Maintain a positive attitude towards the facility 
• Attend required orientations, meetings, and in-service 
• Demonstrate a commitment to flexible work scheduling when necessary to ensure patient care. 

Qualifications 

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Education and Experience

Minimum required education: High School Diploma or equivalent 

Preferred education: Course(s) in medical terminology, revenue cycle certification  

Experience: Five (5) or more years' current hospital or medical office experience required