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Insurance Verification Specialist

3 months ago


Lake Mary, United States Adept Surgical Billing Solution Full time

Seeking an experienced professional who enjoys Verification of Benefits and upfront collections. The applicant should display a positive and proactive attitude, strong organizational skills, the ability to prioritize and be a good communicator, both in writing and over the phone. This position requires frequent contact with insurance companies, physician office staff, and patients.

**Job Duties**:

- Solid understanding of medical insurance benefits including deductibles, copay and coinsurance.
- Previous experience processing provider referrals and prior authorization requests.
- Previous experience with verifying and interrupting medical benefits for Medicare, Medicaid and major commercial health insurance and secondary payers required.
- Understanding of medical terminology, CPT, and ICD-10 codes.
- Verify patient eligibility via payer websites or telephone to determine coverage of benefits and to calculate patient responsibility for services scheduled based on effective fee schedules.
- Add or update patient insurance primary and/or secondary in the billing system as necessary.
- Ensure complete and accurate information maintained in patient account including authorization or referral received from payer or referring provider.
- Report any trouble findings to management for decision making or coordinate with provider office as necessary such as non-covered services, authorization not approved, or other.
- Work up ABN or Advance Notices for patients who have questionable or known-non-coverage.
- Collect pre-payment by credit card where possible.
- Coordinate handling of upfront collection process and delivery of collection list to client staff.
- Determine existing patient account status, include outstanding balance or collection balance.
- Address prior balance with collection of new services.
- Follow up with patients in past due status.
- Handle patient billing calls and inquiries, address with co-workers or management as necessary.
- Review accounts for recommendations of collections, bad debt, and other.
- Assist with work up and issuance of patient refunds.
- Maintain confidentiality and adhere to HIPAA regulations when handling patient information.
- Handle other tasks as directed by management.
- Strong people skills required; positive, motivated, team player, flexible and organized.
- This is a remote position which the business can hire in the states of FL and TX

++Christian Based Workplace

Note: This job description is intended to provide a general overview of the position. It is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the role.

Pay: $17.00 - $20.00 per hour

Expected hours: No more than 40 per week

**Benefits**:

- 401(k)
- 401(k) matching
- Disability insurance

Weekly day range:

- Monday to Friday

Work Location: Remote