Insurance Verification Specialist

POSITION SUMMARY

The Insurance Verification Specialist is responsible for verifying patient insurance coverage for appropriate reimbursement. This position serves as an initial point of contact for new patients, responsible for gathering demographic information, verifying insurance coverage, and requesting outside medical records. Coordinates information with the case management department and physician office to ensure pre-certification is obtained. Communicate with clients prior to service to establish payment expectations and initiate financial counseling. Ensures accurate liability is maintained on patient accounts.

ESSENTIAL FUNCTIONS

• To complete accurate and timely verification of insurance for appropriate reimbursement
• To communicate with clients prior to service to establish payment expectations and initiate financial counseling
• Effectively and efficiently verify all insurance benefits for all services to determine insurance coverage
• Efficiently maintains department records, reports and files as required, entering pre-certification numbers timely
• Consistently refers uninsured and underinsured patients for financial assistance
• Obtain and verify Eligibility and Benefits information for patients
• Process pre-registration documents, and forwards to appropriate department
• Interact with physician offices and patients in a timely courteous manner
• Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients
• Obtain referring provider notes for new patient appointments
• Performs other duties as assigned
• Comply with all policies and standards

Qualifications:

• Minimum of 3 years of experience in medical insurance verification or related field
• Must have experience working with insurance companies and have extensive knowledge of different types of coverage and policies
• Must have excellent multitasking skills, with the ability to work on many projects
• Must be very detail-oriented and organized to maintain accurate patient insurance records
• Working knowledge of medical terminology and are familiar with insurance and billing policies and procedures
• Must have previous experience with insurance portals

KNOWLEDGE/SKILLS/ABILITIES:

• Ability to read, write and communicate and present a neat professional appearance.
• Familiarity with medical terminology and experience in a customer service environment preferred
• Experience with computers
• Word processing and computer experience a must.
• Must be organized and detail oriented
• Create a good impression as a friendly, empathetic, composed, and efficient individual to the patient
• Demonstrate reliability, a pleasant attitude, and a willingness to perform the duties as required
• Ability to maintain and comply with patient confidentiality and integrity policy on all matters

EDUCATION | EXPERIENCE

• High school diploma or equivalent required
• One (1) year of work experience, preferably in a medical office

PHYSICAL DEMANDS AND WORK ENVIRONMENT