What are the responsibilities and job description for the Medical Insurance Specialist position at REAL TIME Medical Supply?
Kind, friendly, positive-minded & supportive workplace:) Come join the team!
Medical Insurance Specialist: Pluses Brightree® software experience & friendly, helpful Customer Service skills::... Definitely multi-tasks skills ^^
Description of Responsibilities:
Monitor and verify insurance information for individual patients and procedures. Staying abreast of co-pays, benefits, coverage and authorizations. Enter data and validate individual and cross-patient information. Posting insurance and patient payments. Following up on claim rejections.
Reporting Relationships: CX Operations Director, CX Operations Manager and AR Director
Responsibilities.
Insurance verification aspect:
Specialist is a health care professional working to ensure that patients' health care benefits cover required procedures.
- Contacts a patient's insurance company to verify coverage levels and works with individuals to educate them on their benefits information and if there are any out of pocket cost.
- This information can be obtained by calling and/or using the specific website to confirm coverage.
- Obtaining referrals/ authorizations for patients when needed.
- Tracking referrals and prior authorizations
- Appealing/ Peer-to-Peer which follows an authorization denial
- Ability to explain benefits/ coverage to patient or doctor
- Calculate the reimbursement charge based on the reimbursement rates provided
- Notify manager with patient account and insurance issues
- Additional miscellaneous clerical as assigned
Claims Follow Up aspect:
- Work aging to follow up on unpaid claims
- Utilize EOBs and communicate with insurances to determine reasons for non-payment and resubmit with corrected information.
- Make sure the insurances that require authorizations have been updated and obtained
- Status claims that seem to not have been resolved within 45 days
- If rejected make sure that you have submitted claim to the correct payor id and/or address
- If claims are not getting reimbursed because of insurance reasons, notify patient to process return of equipment
- Additional miscellaneous clerical as assigned
Minimum Qualifications
High school graduate or equivalent.
1-year Insurance Verification experience or Education Certification in field.
Proficient in computer applications and phone systems.
Physical Demands for the job
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
1. The employee is regularly required to stand, walk, and sit, as well as talk and hear.
2. The employee is required to use hands to operate office equipment.
3. The employee must occasionally lift and/or move up to 20 pounds.
Job Type: Full-time
Pay: $15.00 - $20.00 per hour
Expected hours: 40 per week
Benefits:
- Dental insurance
- Employee assistance program
- Flexible schedule
- Flexible spending account
- Health insurance
- Paid time off
Education:
- High school or equivalent (Preferred)
Experience:
- Insurance verification: 1 year (Required)
- Customer Service: 1 year (Required)
Work Location: In person
Salary : $15 - $20