Insurance Claims Specialist

6 days ago


Austin, Texas, United States Centene Corporation Full time
Job Summary

Centene Corporation is seeking a highly skilled Insurance Verification Specialist to join our team. As a key member of our organization, you will play a critical role in ensuring the accuracy and efficiency of our insurance verification processes.

Key Responsibilities
  • Obtain and verify complete insurance information, including prior authorization processes, copay assistance, and coordination of benefits.
  • Perform prior authorizations as required by payor sources, including procurement of needed documentation by collaborating with physician offices and insurance companies.
  • Collect clinical information such as lab values, diagnosis codes, and other relevant data.
  • Determine patient financial responsibilities as stated by insurance providers.
  • Configure coordination of benefits information on every referral.
  • Ensure assignment of benefits are obtained and on file for Medicare claims.
  • Bill insurance companies for therapies provided.
  • Document all pertinent communication with patients, physicians, and insurance companies as it relates to collection procedures.
  • Identify and coordinate patient resources related to reimbursement, such as copay cards, third-party assistance programs, and manufacturer assistance programs.
  • Handle inbound calls from patients, physician offices, and/or insurance companies.
  • Resolve claim rejections for eligibility, coverage, and other issues.
Requirements
  • High school diploma with 1+ years of medical billing or insurance verification experience.
  • Bachelor's degree in a related field can substitute for experience.
  • Experience with payors and prior authorization preferred.
What We Offer
  • Competitive pay rate of $26.20 per hour.
  • A comprehensive benefits package, including health insurance, 401K, and stock purchase plans.
  • Tuition reimbursement and paid time off plus holidays.
  • A flexible approach to work with remote, hybrid, field, or office work schedules.

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