Insurance Eligibility Coordinator

1 week ago

West End, United States Pinehurst Medical Full time
Job Overview

Pinehurst Medical Clinic (PMC)

Pinehurst Medical Clinic is a prominent healthcare institution serving the communities of Moore County, Lee County, Cumberland County, Chatham County, and nearby regions. As a locally owned and operated entity, PMC provides a comprehensive array of primary and specialized medical services. Our dedicated team of physicians and healthcare professionals is committed to delivering patient-centered care, leveraging the latest advancements in medical technology. This unique blend of innovative healthcare and genuine compassion has defined PMC since its inception in 1952. With over 130 providers and approximately 750 staff members across 16 locations, we are dedicated to our mission.

Employee Benefits:

At PMC, we prioritize the overall health and well-being of our employees, ensuring they can excel both personally and professionally. As part of our team, you will receive a robust benefits package designed to support your health, family, and future. For more details on our benefits, please refer to our benefit overview guide.

Role of the Insurance Verification Specialist

As an Insurance Verification Specialist, your primary responsibilities will include reviewing, confirming, and updating payer information prior to the pre-certification process. You will also assess insurance eligibility and identify the appropriate payer for patients on the date of service. This role involves maintaining accurate insurance records, verifying dates, and adding relevant comments in the APM system.

A Typical Day as an Insurance Verification Specialist:

  • Proactively review eligibility information from payers in APM for all services requiring pre-certifications.
  • Evaluate payer coverage against the date of service for all pre-certification services.
  • Access payer websites to verify the correct payer for the date of service.
  • Update and confirm accurate information in APM by completing necessary fields, including verification dates.
  • Provide training for other team members to ensure coverage during peak periods or absences as directed by management.
  • Participate in meetings and professional development sessions as needed.
  • Perform additional duties as assigned.

Required Qualifications:

  • High school diploma or equivalent (GED); or one to three months of related experience and/or training; or a combination of education and experience.

Preferred Qualifications:

  • Experience in data entry operations.
  • Detail-oriented with a strong emphasis on financial accuracy.
  • Experience in a medical office setting is preferred; insurance processing experience is highly desirable.

Work Schedule: Day Shift (Monday through Friday), no weekends or holidays.

Compensation: Hourly (Non-Exempt)

Pinehurst Medical Clinic is an equal opportunity employer, committed to compliance with all state, federal, and local regulations, and provides equal employment opportunities to all individuals regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by law.

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