Medical Insurance Verification Specialist
4 days ago
Premier Medical Resources is a healthcare management company seeking a skilled Insurance Verification Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for verifying patient insurance coverage, ensuring accurate financial clearance, and communicating with patients and healthcare providers.
Key Responsibilities:
- Verify patient insurance coverage and benefits through online portals, phone calls, and other resources
- Resolve coverage issues and update patient Electronic Medical Records (EMR)
- Enter accurate insurance coverage information into patient EMR
- Serve as a liaison between patients, facilities, physicians, and other departments to ensure timely and accurate financial clearance
- Identify patient accounts based on self-pay, PPO, HMO, personal injury, workmen's compensation, or other managed care organizations
- Collect relevant data for eligibility and benefit verification, including ICD-10 and billable CPT codes
- Communicate with internal and external individuals to obtain information, resolve benefit issues, and ensure accurate benefit information
- Respond to inquiries regarding patient accounts with accurate and professional information
- Ensure accounts are financially secured by reviewing and documenting benefits, patient responsibilities, authorization requirements, and other relevant information
- Create financial arrangements with management when a patient is unable to complete payment
- Collaborate with billing and coding departments to ensure correct processing of claims
Requirements:
- High School Diploma or GED
- One (1) year of hospital revenue cycle experience
- One (1) year of general customer service experience
- Broad knowledge of HIPAA, federal, and state regulations
- Ability to work independently and function within a team
- Strong knowledge of managed care, medical terminology, CPT Coding, and ICD-10
- Knowledge of payor guidelines, including reading, understanding, and interpreting medical records and payor requirements
Benefits:
- 3 Medical Plans
- 2 Dental Plans
- 2 Vision Plans
- Employee Assistant Program
- Short- and Long-Term Disability Insurance
- Accidental Death & Dismemberment Plan
- 401(k) with a 2-year vesting
- PTO + Holidays
Please visit our website for more information:
www.pmr-healthcare.com
Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.
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