What are the responsibilities and job description for the Insurance Verification Representative position at Midwest Orthopaedic Consultants?
Excellent opportunity for an Insurance Verification Representative to join an innovative, growth-oriented Orthopaedic practice who has earned a reputation for excellence and is highly respected by their colleagues, patients and the community.
The Insurance Verification Representative researches and obtains patient benefit information, regarding patients' insurance coverage, in order to ensure appropriate reimbursement and help in facilitating patients' treatment.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Responsible for the timely verification of medical insurance benefits for the service scheduled or service being provided via website and/or calling the payer (Managed Care payors, Governmental/State payors, Commercial payers, Workers Compensation, Motor vehicle accident cases)
- Contacts insurance companies to verify primary and secondary insurance coverage for both in-network and/or out of network benefits
- Works with the various departments to ensure necessary referrals, pre-certification and/or authorizations for scheduled services are obtained and on file are obtained and on file
- Reviews and resolves preauthorization/precertification/referral issues that are not valid and contacts insurance companies to verify/validate requirements to ensure accuracy and avoid potential billing denials
- Carefully researches patient benefits with health exchanges and communicates with patient, Asst. Manager of Patient Accts, billing staff and medical providers prior to scheduled appointments
- Strong emphasis will be placed on customer service and service excellence
- Must be able to obtain information to respond to difficult patient and insurance inquiries
- Maintain current knowledge and understanding of government rules and regulations
- Answers patient questions, inquires and concerns regarding their benefits
- Other duties may be assigned.
COMPETENCIES:
- Knowledge of ICD-10, CPT, HCPCS and Medical terminology.
- Excellent interpersonal, communication and customer service skills are required.
- Strong analytical and problem solving skills.
- Excellent verbal and written communication skills are a must.
- Ability to define problems collects data, establish facts, and draw valid conclusions.
- Maintain HIPAA confidentiality.
EDUCATION AND EXPERIENCE REQUIRED:
- High school diploma or GED required and one year college or technical school highly desired.
- A minimum of 2-3 years' experience in healthcare insurance billing, verification, collections and/or authorization is required.
Working Conditions/Physical Demands:
- Must be able to sit and work at a computer for extended periods
- Requires manual and finger dexterity and vision corrected to normal range.
Midwest Orthopaedic Consultants is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, Veteran status, disability or national origin.
