Insurance Documentation Specialist

6 days ago


Nampa Idaho, United States Norco, Inc Full time

Job Title: Qualification Specialist - Insurance Verification Team

Job Summary:

Norco, Inc. is seeking a highly skilled Qualification Specialist to join our Insurance Verification Team. As a key member of our team, you will play a critical role in ensuring that medical documentation is accurate and gathered in an efficient and timely manner for all orders.

Key Responsibilities:

  • Have in-depth knowledge of the documentation requirements for payers and product categories for which Norco provides services.
  • Stay up-to-date with insurance company policy manuals, fee schedules, and contracts.
  • Perform thorough insurance verification to ensure accurate coverage.
  • Gather medical documentation required to meet specific insurance company guidelines.
  • Submit and obtain insurance prior authorizations via secure online portals or mail.
  • Review documentation to ensure pay coverage criteria is met when prior authorizations cannot be obtained.
  • Follow up with therapists and physicians to ensure timely receipt of documentation.
  • Stay abreast of industry updates and Medicare changes.
  • Perform other tasks as assigned or necessary to support the team.

Requirements:

  • Strong knowledge of insurance documentation requirements and industry standards.
  • Excellent communication and organizational skills.
  • Ability to work in a fast-paced environment and meet deadlines.
  • Proficiency in using online portals and software applications.


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