What are the responsibilities and job description for the (Contract) Medical Insurance Verification Specialist position at pMD?
We hold ourselves to exceptionally high standards in order to provide unparalleled service to healthcare professionals, their staff and patients. We strive to end each workday knowing that we've made someone's life better.
Our team is comprised of courageous and caring healthcare warriors. We're here to solve the impossible problems, such as reducing medical errors, saving patient lives, and empowering physicians to stay financially independent. We care deeply about making a big impact and we are relentless.
Inspired to grow the company and our careers, we remain committed to daily discipline, self improvement, and a ceaseless search for solutions.
We equally value our work and our life apart from work. We're compelled to work with urgency, decisiveness, and efficiency in everything we do. This affords us freedom and time for things that matter most.
Leaders at pMD are developed through our mentorship program. Investing in the success of each individual strengthens our team and builds loyalty. We believe in leading by example. Everything one does ripples outward. Therefore, we need each individual at pMD to embody our leadership principles to thrive as an enduring great company.
Contract) Medical Insurance Verification Specialist
The (Contract) Medical Insurance Verification role at pMD is responsible for performing detailed insurance benefit verifications of all patients' prior to claim submission to the carrier. This is an important role in identifying active coverage under the correct policy, while effectively communicating with third-party payers.
Responsibilities include :
- verifying a patient has active coverage with the insured carrier following an inpatient encounter using an electronic eligibility solution
- if the carrier returns ineligible, identify the correct coverage by leveraging the integrated eligibility tool, HL7 interface message, or attached facesheet. If a patient is identified as self-pay, update the financial class
- when coverage returns that an advantage plan has been detected, identify the correct carrier and policy number to be billed using an eligibility solution. Update insurance information in the patient's record based on the eligibility response
- identify the correct policy to be billed when a patient is identified as being enrolled in hospice by referencing the eligibility response
- for carriers that do not offer an electronic eligibility response, contact the carrier by phone to complete the verification. A carrier contact list will be provided to facilitate outreach
Requirements include :
The compensation model for this role is designed to pay on a per-unit of completed work basis. Payment is $0.92 per patient encounter or appointment verified. Our specialists typically review and verify an average of 22 accounts per hour, but the choice is yours!
There are no minimum requirements for working hours or hours per day for this position. Work is available on a first come, first serve basis, and you have complete flexibility on how many encounters you want to review based on your free time and to meet your compensation goals.
We are only accepting applications through our online job portal, Lever. We aren't able to consider and respond to other types of applications, including those sent via email to pMD support, at this time. Please direct application status questions to recruiting@pmd.com.
Candidates must be authorized to work in the U.S. as a precondition of employment.
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