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Insurance Verification Specialist

3 months ago

Tallahassee, United States Southern Vitreoretinal Full time
Job DescriptionJob Description

JOB SUMMARY: Southern Vitreoretinal Associates (SVA) Insurance Verification and Funding Specialist, under direction of the Assistant Business Office Manager, will verify insurance coverage and benefits for patients with upcoming appointments based on SVA’s policies.

PRIMARY AREAS OF RESPONSIBILITIES: The duties identified below are the essential functions of the position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned that align with the summary of this position.

  1. Verifies patient insurance coverage and benefits for all upcoming SVA appointments based on SVA policies. Utilizes various methods of verification including (but not limited to): Real-Time eligibility, various insurance portals, phone calls, websites.
  2. After confirming necessary authorizations are in place, will provide approval to clinics for same day injections, so that a patient can receive treatment.
  3. Ability to understand and explain patient accounts, in order to answer incoming phone calls from patients and resolve their questions, concerns, or issues.
  4. May call the patient when necessary to obtain current information needed to correctly verify the patient's insurance and benefits.

ACCOUNTABILITIES:

  1. Facilitates the rapid and successful conversion of patient revenue into cash, minimize debt, improve cash flow and manage overall health of the Clinic’s receivables.
  2. Reinforces and abides by our SVA’s core values of integrity, respect, and trust. Ensures direct reports abide by the same core values.
  3. Facilitates the rapid and successful conversion of patient revenue into cash, minimize debt, improve cash flow and manage overall health of the Clinic’s receivables.

EXPECTATIONS:

  1. Reinforces and abides by SVA’s core values. Ensures direct reports abide by the same core values
  2. Ensures high level of customer service, compassionate, patient-centered care to patients.
  3. Collaborates across the organization to develop, implement, and maintain processes that positively impact the revenue cycle.
  1. Understands and complies with all laws, rules, regulations, policies, and procedures applicable to the position.
  2. Utilizes a variety of office technology, to capture and document services provided, ensuring an accurate billing record.
  1. Excellent written, verbal and presentation skills necessary to facilitate accurate communication with providers and staff, providing a consistent message.

EDUCATION AND EXPERIENCE:

EXPERIENCE:

  1. High School diploma or equivalent.
  2. Well organized and detail oriented.
  3. Working knowledge/experience with EHR/medical billing software.
  4. Understanding of private insurance rules and regulations.

INTENT AND FUNCTION OF POSITION DESCRIPTIONS

This position description is intended to cover the most significant aspects of the position. There may be additional responsibilities assigned beyond those stated in this position description. The Company reserves the right to modify the role, responsibilities, requirements and position status as compliance regulations or business needs dictate. Position descriptions assist the company in assuring the hiring process is administered fairly and qualified candidates are selected. They are essential to effective performance management and compensation systems. In accordance with the Americans with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals. However, no accommodations will be made which may pose serious health or safety risks to the team member or others or which would impose undue hardship on the Company. Position descriptions are not intended as and do not create employment contracts. The Company maintains its status as an at-will employer and employment separations can occur for any reason not prohibited by law.