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Insurance Eligibility Coordinator

2 months ago

Austin, Texas, United States Advanced Pain Care Full time
Job Overview

POSITION SUMMARY:

The Insurance Verification Specialist plays a crucial role in administrative tasks that encompass the validation of insurance details, calculating estimated patient financial responsibilities for services rendered, and resolving any insurance-related issues for all patients scheduled for care. This position operates within the established policies and procedures throughout the organization.

ESSENTIAL QUALIFICATIONS:

  • High school diploma along with a minimum of 1 year of relevant experience and/or training, or an equivalent combination of education and experience. Experience should include familiarity with payer eligibility electronic returns and the ability to distinguish between various insurance plans, copayments, deductibles, and coinsurance.
  • Strong problem-solving abilities and sound judgment.
  • Capability to collaborate across departments and foster effective relationships with both internal and external stakeholders to meet objectives.
  • Understanding of customer service principles and practices.
  • Aim to achieve team objectives while exemplifying organizational values and utilizing resources efficiently.
  • Proactive approach and initiative in work tasks.
  • High attention to detail, accuracy, and monitoring of work to ensure quality.
  • Strong organizational skills.
  • Excellent verbal and written communication skills, alongside exceptional interpersonal abilities.

KEY RESPONSIBILITIES:

  • Become familiar with the insurance carriers contracted with Advanced Pain Care.
  • Conduct phone calls to patients, their families, insurance companies, and facility personnel to gather necessary information for verification.
  • Maintain patient demographic information and data collection systems.
  • Verify insurance eligibility for upcoming appointments through online resources or direct communication with carriers.
  • Review patient deductibles and/or copays and input this information into the billing system used by front-end staff across all locations.
  • Assist front-end and call center staff in navigating carrier websites and verifying eligibility.
  • Address inquiries from patients, clerical staff, and insurance companies.
  • Perform miscellaneous job-related duties as assigned.
  • Uphold the highest level of confidentiality; comply with all HIPAA regulations; adhere to organizational policies and procedures.

WORKING RELATIONSHIPS:

Direct Supervision: Director of Patient Access

WORK ENVIRONMENT:

Environmental Conditions:

  • Medical Office setting

Physical Requirements:

  • Ability to work as scheduled.
  • Capability to sit and/or stand for extended periods.
  • Responsibilities may involve moving materials weighing up to 30 lbs.
  • Required hand-eye coordination and manual dexterity sufficient to operate office equipment.