Insurance Verification Specialist

Job Description

REQUIREMENTS

High school diploma

Medical terminology

Two years’ experience in medical insurance plans or benefit verification practices

Excellent written and verbal communication skills

Ability to read and understand explanations of medical benefits.

RESPONSIBILITIES

Responsible for the timely verification of medical insurance benefits for new patients, existing patients with changes in insurance, and reactivated patients.

Review and update patient accounts with insurance policy information and process requests accurately.

Notate each account with a clear summary of patient eligibility and insurance benefits received from the carrier.

Call government funded and commercial insurance companies to obtain prior authorizations or referrals.

Determine the correct Coordination of Benefits.

Complete verification requests confirming the correct network status through the company’s contracts with insurance payers to determine member benefit coverage.

Ensure all insurance, demographic and eligibility information is obtained, and entered in the system in an accurate manner.

Responsible for reviewing customer files for missing insurance information required to bill for services rendered.

Perform financial review on existing accounts to identify benefit issues.

Assist in maintaining inbound faxes, manuals, logs, and other documentation as required.

Complete insurance verification and summary of reimbursement, and liability forms.

Advise the Manager of verification trends and updates.

Meets individual, departmental, and company goals.

Are you interested in this position?

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