Insurance Verification Specialist

JOB DESCRIPTION- INSURANCE VERIFICATION SPECIALIST

GENERAL DESCRIPTION

A health care professional working to ensure that patients' health care benefits cover required procedures. The specialist contacts a patient's insurance company to verify coverage levels and works with individuals to educate them on their benefits information.

REPORTING RELATIONSHIPS

The Insurance Verification Specialist reports directly to the Billing Supervisor and Director of Operations.

QUALIFICATIONS

• Understands the importance of maintaining confidentiality; able to maintain confidentiality under HIPAA standards
• Must have the ability to exercise a high degree of diplomacy and tact; excellent customer services and interpersonal communication skills; Cultural sensitivity and demonstrated ability to work with diverse people groups
• Intermediate to advanced knowledge of insurance coverage and policies
• Excellent multitasking skills
• Detailed-oriented and organized
• Ability to focus and work quickly to process paperwork in timely manner
• Knowledge of basic math and modern office procedures
• Basic to intermediate computer knowledge and skills
• Ability to work well with various members of health care team
• Ability to effectively communicate with various departments

SPECIFIC RESPONSIBILITIES

• Validate individual and cross-patient insurance information for upcoming appointments
• Perform accurate and concise data entry into practice management system
• Obtain insurance referrals and authorizations as required
• Communicate with patients about co-pays, benefits, coverage and care authorization
• Liaise with patient, insurer and clinical team to communicate needs and current state of coverage
• Perform other duties as may be required

MEASUREABLE GOALS

• Verifies insurance coverage for all patients identified as failing and/or not processed by RTS program in 5-day increments 100% of the time
• Obtains authorizations as required 100% of the time
• Notifies patients regarding lack of coverage for upcoming appointments 100% of the time

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an
employee to successfully perform the essential functions of this position. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential
functions.

While performing the duties of this job, the employee will be required to:

• sit, talk, hear, and use fine motor skills for extended periods of time
• The employee will also occasionally be required to stand, walk, climb, balance, stoop, kneel, crouch, crawl, and reach with hands and arms
• The employee will occasionally be required to lift and/or move up to 25 pounds
• The employee must have adequate (with correction) close vision, distance vision, depth perception, and the ability to adjust focus

WORK ENVIONMENT

The work environment characteristics described here are representative of those an employee
encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• There is no significant exposure to extreme environmental conditions.
• The noise level in the work environment is usually moderate with voices, office equipment, and foot traffic sounds often being present.
• The employee may occasionally be required to travel to off-site meeting or training

locations where different environmental conditions may exist.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• Medical billing: 1 year (Preferred)
• Insurance verification: 1 year (Required)

Work Location: In person