What are the responsibilities and job description for the Insurance Verification Specialist position at CRO Services LLC?
SUMMARY
The insurance verification specialist is responsible for obtaining verification of all insurance benefits for patients and maintains that information to reflect the most up to date coverage. Performs data entry for new patient accounts and/or existing patient accounts. Works closely with patients, insurance companies, and clinical staff members as needed.
Performs the following duties personally and coordinates with team members to ensure successful completion of assigned tasks.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
Essential Duties:
1. Accurate verification of all insurance benefits, and entry of new or updated insurance information for all patient accounts
2. Add/Create new accounts as needed in UF
3. Enter new patient demographics and maintain existing patient demographic profiles.
4. Review schedule for upcoming new patient and treatment patient appointments to ensure all
authorizations and insurances are in place
5. Work closely with authorization coordinator to obtain authorizations in the absence of the coordinator
6. Call insurance companies to resolve authorization issues
7. Maintain a professional relationship with physician teams
8. Maintain patient and clinic confidentiality
9. Assisting with answering and attending phone calls when needed
10. Assisting with the front desk workflow when needed
11. Perform all related duties as required by Office and Operations Manager and Regional Director
Responsibilities
- Work co-operatively within a multidisciplinary team and assist other team members to achieve team objectives and work outcomes
- Provide excellent customer service
- Ability to navigate numerous insurance portals to review benefit coverage details
This job description in no way states or implies that these are the only duties to be performed by this employee. He or she will be required to follow any other instructions and to perform any other duties requested by his or her supervisor.
SUPERVISORY RESPONSIBILITIES
This job has no supervisory responsibilities.
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
- One year of experience
- High School certificate or GED required
- Demonstrated ability in an administrative role within a busy, customer focused environment, medical preferred
- Experience in handling and resolving urgent matters and time critical medical appointments
- Ability to use clinical administration systems, as well as Microsoft Office software
MENTAL DEMANDS
Language Skills Experience
Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
Mathematical Skills Experience
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret line graphs.
Reasoning Ability
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
Computer Skills
To perform this job successfully, an individual should have basic to intermediate knowledge of: Microsoft Office Suite: particularly Outlook Communication Management software, Word, and Excel. Knowledge of patient billing systems and related funding mechanisms. Experience with Internet usage, PC and/or MAC and Windows.
OTHER SKILLS AND ABILITIES
- Collaborative approach in working with the wider administration team and other internal customers, in line with the organization values.
- Flexible approach to work
- Strong organization and communication skills, with the ability to liaise with both internal and external stakeholders.
- Attention to detail.
- Proven experience working effectively both independently and in a team environment.
- Communicate clearly and concisely, both orally and in writing.
- Ability to understand and carry out verbal and written directions.
- Follow CRO policies and procedures.
- Ability to work independently in the absence of supervision.
Other requirements:
- Must properly control the release of proprietary and confidential information.
- Travel as required to other centers.