What are the responsibilities and job description for the Insurance Verification Specialist position at Prospect CharterCARE Health Partners?
Summary: The Insurance Verification Specialist completes the daily verification and authorization process of all in and outpatient cases in the Charter Care Health Partners network. This process requires extensive knowledge of all third party contracts as they pertain to obtaining reimbursement for inpatient admissions and observation patients. The Specialist works closely with admitting, case management and the business office to assure the accuracy of information and timeliness of the verification/notification process. The Specialist will contact physician offices, Federal & State Agencies and third parties to obtain information required to assure payment of inpatient claims. The Specialist will meet daily with the Insurance Verification Coordinator to discuss specific issues including but not limited to private pay admissions, scheduled un-authorized admissions, or any case that could result in non-reimbursable visits.
Education/Experience: Two years of college, or 3-5 years experience in a Medical Business Office setting. Experienced in computer automated billing & collection process. Knowledge of third party regulations and compliance issues. Excellent verbal and written communication skills.
Employment Type: Full Time regular (64-80 hrs) Shift: 1 Hours: 7:00 am - 3:30 pm
