Team Lead-Surgical Insurance Verification

About the Practice:

The physicians of Heaton Eye Associates have been serving East Texas’ vision needs for over 40 years. We offer state-of-the-art technology with special services ranging from primary eye care to world-class laser surgery. Our physicians were the first to offer LASIK laser vision correction in East Texas and have performed tens of thousands of procedures since its inception. Heaton Eye offers a wide range of premium lenses including Symfony Extended Depth of Focus lenses, PanOptix® lenses, and Vivity® lenses to offer freedom from glasses and contacts after cataract surgery. Our surgeons were the first in East Texas to offer the RxSight Light Adjustable Lens, the only lens implant that allows patients to preview and adjust their vision after cataract surgery. We are the first and only practice in the area offering EVO ICL, another exciting option offering patients freedom from contacts and glasses. Additionally, we have the only fellowship-trained Pediatric Specialist as well as the only Oculoplastic Surgeon offering cosmetic, medical, and reconstructive surgery as well as state-of-the-art aesthetic services in the area. The extensive care and energy Heaton Eye Associates puts into maintaining our leadership position on information and technology in the rapidly evolving science of ophthalmology reflects our commitment to our patients.

About the Area:

Our East Texas locations in Tyler, Longview and Athens offer year-round activities the entire family can enjoy. In Longview, you can experience Texas' rich history and culture. Tyler is surrounded by 25 prime sporting lakes, offering wonderful opportunities for fishing and boating. In the spring, Tyler residents enjoy the colorful spring flowers. Athens, whose tagline is Hamburgers-Heritage-Texas, has the charm of a small, southern town while still retaining many qualities of a larger city and is home to the East Texas Arboretum and Botanical Society.

Seeking an Exceptional Lead Surgical Insurance Verification Specialist | Heaton Eye Associates | Full-Time | Monday-Friday

Job Summary and Responsibilities:

Under the direction of the Associate Director, verify surgical benefits, maintain insurance authorizations for current patients, Re-verify insurance coverage as needed. Research and follow-up on authorization denials, when other Insurance Verification Specialists are absent or not available, provide backup coverage.

Supervisor/Leadership Responsibilities:

Lead Role - Provides technical and advanced knowledge-based expertise to others and/or provides input into hiring, firing, discipline.

Certification/Licensures:

None Required

Education:

High School Diploma or equivalent

Experience:

• Previous experience in surgical insurance verification is a must, a plus for experience in ophthalmology
• Strong understanding of pre-authorizations and pre-determinations
• Strong understanding of medical terminology and insurance practices
• Exceptional attention to detail and accuracy in verification processes
• Excellent communication skills, both verbal and written, with the ability to interact effectively with patients, insurance companies, and leadership
• Proficiency in using computer systems and software applications relevant to insurance verification and healthcare administration
• Ability to work independently and collaboratively within a team environment

Primary Job Duties and Accountabilities:

• Verify surgical insurance coverage and eligibility for patients, as well as requesting pre-authorizations, predeterminations, ensuring accurate and timely processing
• Communicate with insurance companies to gather necessary information regarding benefits and coverage details
• Review patient information to confirm accuracy and completeness of insurance details
• Collaborate with leadership/verification team, as well as patients to resolve insurance-related inquiries and issues
• Maintain detailed records of verification activities and update patient accounts accordingly
• Stay informed about changes in insurance policies, procedures, and regulations affecting verification processes
• Provide support to billing and leadership by offering insights into coverage details that impact billing and reimbursement
• Assist patients in understanding their insurance benefits and responsibilities
• Be available for your team and leadership as needed for questions, further education, and problem solving
• Fulfillment of core values
• All other duties as assigned

Benefits:

• Affordable Health and Dental
• Vision Care
• Life Insurance
• PTO
• 401K