Lead Insurance Verification Specialist

Heart and Vascular Partners is a fast-paced, growing heart and vascular MSO seeking a Lead Insurance Verification Specialist! As the Lead Insurance Verification Specialist, you will be responsible for verifying insurance coverage for patients and ensuring that appropriate billing practices are followed. Your role will involve overseeing the daily operations of the insurance verification department, providing guidance, and training to department staff, and identifying and resolving any issues that arise. You will be a key player in helping to ensure accuracy and efficiency in the insurance verification process. If you are an organized and detail-oriented individual looking to make a positive impact in a healthcare setting, then this is the perfect role for you!

Essential Functions of the Role:

• Verify patient insurance benefits
• Explain insurance coverage and treatment costs and identify the need for any pre-authorizations
• Work with payers to obtain pre-authorizations necessary
• Advise patients of coverage, limitations and exclusions, co-insurance, deductible, special
• program requirements
• Communicate coverage, via electronic, phone, and in person communications
• Determine patient responsibility amounts in advance of the related procedures
• Serve as a Patient Advocate for patients when patients have difficulty navigating with their insurance company
• Communicate to management about pre-authorization requirements and any update any changes
• Update patient accounts, including verification of insurance coverage and changes in patient information, with appropriate documentation.
• Respond to a high volume of telephone inquiries in a positive and professional manner, resolve and follow up on all issues within designated timeframes.
• Meet positional metrics and benchmarks.
• Maintain the highest degree of ethics when handling patient payments and bill processing
• Follow all department standard operating procedures carefully and accurately
• Assist manager with timecard corrections and time off request
• Assist manager with the Insurance verification specialist with quarterly reviews 
• Lead and Mentor teammates as needed
• Other duties as assigned 

Minimum Qualifications:

• 2 years of benefit verification strongly preferred
• 3 years of healthcare front reception billing experience in a fast-paced, customer focused environment a plus
• Possess a strong working knowledge of insurance benefits, Managed Care policies
• Strong written and verbal communication skills & a team player
• Willingness to be flexible, roll with the punches, multi-task and troubleshoot problems
• Detail oriented with strong organizational skills
• Exemplifies amazing customer service skills and professionalism
• Medical terminology

Remote Work Requirements

• Must be available to work during scheduled work hours, except for lunch and breaks 
• A Quiet, distraction-free environment 
• High-speed private internet connection
• Respond to all non-urgent calls and emails withing 1 business day
• Notify your manager immediately for any technical and/ or access issues that prevent you from completing your work
• Notify your manager at least 30 minutes prior to your scheduled start time for any unplanned days off

Lead Duties:

• Team management to include timecard approval and tracking
• Mentoring and Development
• Decision making and Problem Solving

Work Environment

This position is a Remote position Monday- Friday from 8:00 am – 5:00 PM. 

Physical Requirements

This position requires full range of body motion. While performing the duties of this job, the employee is regularly required to sit, walk, and stand; talk or hear, both in person and by telephone; use hands repetitively to handle or operate standard office equipment; reach with hands and arms; and lift up to 25 pounds. 

Equal Employment Opportunity Statement

We provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.   This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Salary and Benefits

Full-time, Exempt position. Competitive compensation and benefits package to include 401K; a full suite of medical, dental, and ancillary benefits; paid time off, and much more.

The statements contained herein are intended to describe the general nature and level of work performed by the Lead Insurance Verification Specialist, but is not a complete list of the responsibilities, duties, or skills required.   Other duties may be assigned as business needs dictate.  Reasonable accommodation may be made to enable qualified individuals with disabilities to perform the essential functions.