Insurance Verification Specialist

Job Description

REQUIREMENTS

• Must have thorough knowledge of all insurance procedures to include, but not limited to, registration requirements, collection of co-pays, co-insurances, deductibles, and allowable procedures and charges HPPA laws and regulations.
• Must have knowledge of maintaining health care records.
• Must be computer literate experience preferred.
• Must be able to deal with all patients or visitors regardless of their temperament with proper decorum.
• Must have excellent organizational skills.
• Bilingual (English/Spanish) desired.
• Must know medical terminology.
• Must have excellent verbal and written communication skills.
• Must possess excellent customer service skills.
• High School Diploma or equivalent
• Minimum of 1-2 years’ experience in administrative medical office setting

RESPONSIBILITIES

• Maintains patient demographic information and data collection systems.
• Verify insurance eligibility for medical insurance for upcoming appointments by utilizing online websites or by contacting the carriers directly.
• Receiving, cataloging, and tracking progress of verification requests received.
• Recognize insurance verifications that need to be transferred to referrals for authorizations.
• Coordinate with front end regarding scheduling errors.
• Assist front end staff and call center staff in understanding carrier websites and verification of eligibility.
• Evaluate insurance for need of a referral.
• Answer questions from patients, clerical staff, and insurance companies.
• Works in conjunction with the front office staff to ensure clean billing.
• Participates in trainings and attends staff meetings.
• Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
• Other duties as assigned.

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