Insurance Verification Specialist (GF)

General Description
TVG-Medulla, LLC provides support and services to two comprehensive chiropractic care companies, Chiro One Wellness Centers and MyoCore Personalized Pain Care, both industry leaders in evidence-based, patient outcomes-centered care.

The insurance verification specialist acts as a customer service and quality assurance liaison between our insurance verification coordinators, insurance companies and our clinical teams to ensure that clinical teams are able to present patients with the most accurate insurance benefits and out of pocket cost for their recommended treatment.

Essential Functions and Responsibilities

1. Perform quality assurance review/analysis on individual insurance policy benefits prior to insurance verifications being released to clinical teams
2. Document and leverage insurance policy coverage patterns to create templates and job aids for verification team
3. Review patient accounts against verified insurance benefits to ensure accurate coverage
4. Work collaboratively with other teams in the department to ensure a seamless patient financial lifecycle
5. Maintain a strong working knowledge of the clinical patient financial lifecycle and intersections between clinical and revenue cycle processes
6. Maintain proficiency in insurance verifications forms, protocols, procedures, websites and proprietary software
7. Act as a customer service resource and liaison for clinical teams in need of guidance and explanation on patient insurance benefits and financials
8. Perform insurance verification phone calls and web-portal tasks as needed
9. Participate cross-functionally with pre-certification tasks as needed
10. Notify management of any strange scenarios, possible compliance concerns or recurring issues.
11. Maintain a positive and professional work environment.

Minimum Qualifications

1. 2 years of insurance verifications experience
2. Strong knowledge of insurance benefits and insurance terminology
3. Exceptional verbal and written communication
4. Strong attention to detail and organization skills
5. Solution-oriented approach to problem-solving
6. Proficiency in Microsoft Office

Job Competencies

1. Ability to multi-task in a dynamic, fast-faced environment
2. Excellent customer service skills
3. Passion for delivering high-quality, accurate results and outcomes
4. Ability to recognize and leverage patterns to enhance efficiency of workflow
5. Ability to think critically

Disclaimer

All team members agree to consistently support compliance and TVG-Medulla, LLC policies and Standards of Excellence with regard to maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, adhering to applicable federal, state, and local laws and regulations, accreditation, and licenser requirements (if applicable), and Medulla procedures and protocols. Must perform other related duties and assist with project completion as needed. Team member may be required to provide necessary information to complete a DMV (or equivalent agency) background check.