Insurance Verification

2 months ago

Springfield, United States New England Dermatology & Laser Center Full time

Description:
**Job Summary** The insurance verification and referral associate is responsible for verifying patient insurance coverage, identifying any patient cost-sharing or expenses, confirming required referrals and ensuring other required documentation is in place prior to patient encounters to ensure a clean billing process. May assist patient services associates with checking in patients for appointments and collecting patient balances as needed. This position provides superior customer service to callers with insurance verification and referral questions and concerns.

**Location **Westfield office. Willingness/ability to travel to other offices as needed.

**Hours **Full-time 40 hours M-F 7:30a-4p with ½ hour non-paid lunch daily. Non-exempt.

**Assumes responsibility for insurance verification, referrals, and billing and payment processes. **(Weight 50%)
- ** Verifies insurance eligibility for upcoming appointments according to established timelines**:Runs Appointment Insurance Eligibility reports for all general dermatology and Mohs providers. Initiates insurance verification. Reviews insurance verification status reports. Exports Appointment reports. Reviews patient information, deductibles and/or copays. Accesses insurance payer websites, telephone numbers, and other resources to obtain benefit and coverage information. Contacts carriers directly via website or phone. Documents initiatives taken, progress and results in resolving verification issues.
- ** Verifies referrals are in place prior to appointment**:Reviews referral status for insurances that require referrals. Obtains and enters insurance referrals into practice management system. Matches referrals to correct patient.
- ** Outreaches patients regarding insurance verification and referral issues**:Contacts patients to advise them of Office Policy and insurance verification issues and referral requirements prior to appointment. Verifies information (demographic, insurance plan and coverage, etc.) is correct in the patient’s account; updates as applicable. Documents initiatives taken, progress made and final results in resolving insurance verification and referral issues.
- ** Performs follow-up on insurance verification and visit referrals daily**:Checks insurance and referral status with clearinghouse and/or carriers for previously failed and rejected verification statuses. Performs account research and analysis and documents reconciliation. Contacts insurance company to follow-up on the status. Updates Appointment report spreadsheets.
- ** Acts as the liaison for insurance verification and referrals**:Maintains knowledge of carrier(s) to be up-to-date and current. Works in conjunction with billing and other departments to ensure accurate collection of insurance information for all patients. Acts as department liaison to assist internal customers with patient insurance inquiries. Assists with insurance verification and referral inquiries. Answers questions from patients, staff, and insurance companies. Communicates changes. Provides insurance verification and training and support to others.
- ** Facilitates positive office experience**:Provides superior customer service. Follows service guidelines and scripts and maintains a calm and pleasant demeanor.
- ** Processes incoming calls**:Answers telephone calls. Responds appropriately to outside and inside insurance verification and referral inquiries per the established protocols. Communicates insurance benefits effectively to ensure patient and staff understanding. Accepts payments. Schedules patient appointments. Documents calls appropriately (clear, concise and detailed, with accurate spelling and grammar).
- ** Performs other duties as assigned.**

**Requirements**:
**Education** High school diploma or GED. Associates Degree preferred.

**Licensure/Certification** Medical billing or coding certification or equivalent experience required.

**Experience** 1-3 years medical office experience, including customer service, insurance, referrals, basic coding knowledge and charge entry required. 2 years collections experience and dermatology experience preferred.

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