Insurance Verification Specialist
7 hours ago
Premier Medical Resources is a healthcare management company seeking a highly 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 providing exceptional customer service.
Key Responsibilities- Verify patient insurance coverage and benefits through online portals, phone calls, and other resources
- Resolves any coverage issues and update patient Electronic Medical Records (EMR)
- Enter insurance coverage (co-payments, deductibles, etc.) accurately into patient EMR
- Serve as a liaison between the patient, facility, physicians, and other departments to ensure timely and accurate financial clearance of all accounts
- 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 all ICD-10 and billable CPT codes per orders
- Communicate with internal and external individuals to obtain information, resolve benefit issues, and ensure accurate benefit information is obtained
- Respond to inquiries regarding patient accounts with appropriate and accurate information in a professional manner
- Ensure accounts are financially secured by reviewing and documenting benefits, patient responsibilities, authorization requirements, and other relevant information
- Create financial arrangements, alongside management, when a patient is unable to complete payment
- Respond promptly to requests and keep open channels of communication with physician, patient, and service areas regarding financial clearance status and resolution
- Collaborate with billing and coding departments to ensure correct processing of claims
- Calculate co-pay, and estimated co-insurance due from patients per the individual payer contract per the individual payer contract and plan as applicable
- High School Diploma or GED
- One (1) year of hospital revenue cycle experience
- One (1) year of general customer service experience
- Broad knowledge of the content, intent, and application of HIPAA, federal and state regulations
- Ability to work independently with little or no supervision as well as function within a team
- Knowledge with in and out of network insurances, insurance verification, patient responsibility, and process for prior authorization
- Good communication skills (verbal / written) providing a great patient experience
- Ability to work effectively in a fast-paced environment
- Strong knowledge of managed care, medical terminology, CPT Coding and ICD10
- Demonstrates use of appropriate modifiers, HIPAA regulations, and insurance verification procedures
- Knowledge of payor guidelines including reading, understanding and interpreting medical records and payor requirements etc.
- 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:
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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