Medical Insurance Verification Specialist

4 weeks ago


Houston, Texas, United States Premier Medical Resources Full time
Job Summary

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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