Insurance Benefits Specialist

3 days ago

Baltimore, Maryland, United States Kennedy Krieger Institute Full time
Job Summary

We are seeking a highly organized and detail-oriented Insurance Verification Specialist to join our team at Kennedy Krieger Institute. In this role, you will be responsible for verifying insurance coverage and benefits, ensuring maximum and prompt payment of services rendered by the referral source and KKI triage staff.

Key Responsibilities
  • Verify insurance coverage and benefits utilizing all available verification and eligibility tools and calls payers when needed.
  • Document all ascertained information into the registration system.
  • Verify and/or obtain the necessary referral, authorization, or pre-certification prior to services being provided as required by the payer.
  • Obtain the patient's information to facilitate the verification of the unique patient identifiers for clinical purposes, billing and collections process, and compliance with state and federal regulatory requirements.
  • Estimate self-pay portions after benefits have been determined (deductibles, co-pays, non-covered services).
  • Document and follows up on efforts to promote team and clinic awareness.
  • Collects up-to-date demographic information from patients and families.
  • Maintains regular communication and follow-up with patients, families, as well as KKI programs/departments, to include: team leaders, Patient Accounting, Finance, etc.
  • Keeps all applicable parties informed of pending referrals, authorizations, unanticipated delays, and/or other potential issues.
  • Forwards supporting documentation in a timely manner to Care Centers, Patient Accounting, and clinical areas where applicable.
  • Maintains browser and all IAMS Error Logs in a timely and accurate manner.
  • Responsible for the accurate, complete, and timely capture and data entry of patients' demographic, financial, and clinical information into the various information systems including pre-registration and/or scanning information systems.
Requirements
  • High School diploma or GED required.
  • Associates degree desirable.
  • 1 year of related experience with insurance benefit verification in a healthcare setting required.
  • 2-3 years EPIC experience preferred.
Benefits

We offer excellent benefits including medical, dental, vision, 401K with match, tuition reimbursement, free parking and child care subsidies. In addition, we offer rich professional development opportunities.

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