What are the responsibilities and job description for the Insurance Verification and Patient A/R Specialist position at Specialists in Rehabilitation Medicine, P.C.?
Principle Duties and Responsibilities:
Accurately and timely review patient insurance benefits via insurance website, fax back or calls to insurance carriers prior to appointments to determine patient responsibility for in office services.
Maintain awareness of insurances accepted, insurance requirements, and all other pertinent data to ensure accurate benefit quotes.
Modify patient dashboard information as needed to ensure appropriate claims submissions.
Assess need for, submit, status and ensure proper registration of authorizations for general services.
Communicate with patients and referring providers offices when additional information is needed to process an authorization.
Knowledge of the authorization process for each insurance company as well as knowledge of the clinical information required to submit for authorization.
Ability to research appropriate processes and/or forms to conduct authorization requests
Able to review and interpret the account ledger to determine outstanding patient responsibility.
Able to review and interpret the patient escrow and credits to determine allocation or re-allocation of payments.
Able to identify when communication with the responsible biller is needed regarding aging insurance balances.
Able to identify and remedy or notify the appropriate biller to ledger inconsistencies.
Contact patients prior to their appointment by phone and text to advise of past due balances or responsibilities, missing or invalid insurance information, lack of authorization or open claim letter or claim status.
Ability to communicate with the patient for remediation of outstanding balances in compliance with SIRM policies.
Able to explain insurance terms, processes or problems in a patient friendly manner to aid in resolution or clarification of issues.
Contact patients with outstanding balances to attempt resolution.
Demonstrates and actively promotes an understanding and commitment to the Employee
Handbook including Compliance, Commitment to My Co-Workers, Standards of Conduct and Code of Ethics.
All other duties and assignments as required.
