Insurance Verification Specialist

InnovaCare Management Services Company, LLC

Pre-certification of benefits for incoming patients entails utilizing the insurance provider portal and in some extend calling insurance providers for verification of patient benefits before the day of appointment.

Responsibilities:

• Verification of Medicare and Medicaid eligibility for patients
• Verification of all Commercial eligibility for patients
• Verification for all Managed Medicare eligibility for patients
• Scan all requested and received eligibility information into the patient account
• Assure that the correct PCP is in the patient demographic in ECW
• Update Insurance information so that patients have the correct information on file.
• Verification personnel must do their job while adhering to insurance and patient confidentiality laws
• Verification personnel would document in the patient demographic as well in the printed scheduled the patient financial obligation once coverage is verified.
• Verification personnel is to also document in the patient demographic as well in the printed scheduled any patient past due balance.
• Assist patient when calling in question of a bill or statement they might have received.
• Communicate with the offices in reference to patient insurances and balances discrepancy found while verifying patient benefits
• Update any claims pending due to insurance information
• Document daily the count of patient eligibility done for each provider
• Provide a monthly report with discrepancy
  
  

Skills and Specifications:

• Interpersonal and communication skills are a must to communicate with patients, insurance providers and billing personnel.
• Must be knowledgeable of Insurance terminology and types of policies.
• Computer literate and have exceptional telephone skills
• High School Diploma or equivalent is required for entry-level positions
• At least one year of experience in a related field