Insurance Verification Specialist

1 week ago


Atlanta, Georgia, United States Shepherd Center Full time
Job Summary

The Insurance Verification Specialist plays a crucial role in the patient financial experience at Shepherd Center, a leading provider of medical treatment, research, and rehabilitation services. This position is responsible for coordinating insurance and benefits verification, pre-certification, and pre-authorization for patients, ensuring seamless and efficient financial processes.

Key Responsibilities
  • Verify patient insurance benefits and obtain necessary documentation for billing purposes.
  • Develop and lead training programs for new staff members to ensure effective knowledge transfer.
  • Collaborate with peers to resolve questions and issues related to insurance and benefits.
  • Utilize online systems and phone communication to verify patient eligibility and benefits.
  • Secure pre-authorizations and ensure timely submission of clinical documentation for pre-certification.
  • Serve as a point of contact for addressing account issues, patient concerns, and billing and insurance questions.
Requirements
  • High school diploma or equivalent required; associate or bachelor's degree in healthcare administration or a related field preferred.
  • Certified Healthcare Access Associate (CHAA) and Certified Patient Account Representative (CPAR) certifications required.
  • Minimum of two years' professional experience in an outpatient setting, rehabilitation center, or as an external case manager.
  • Knowledge of commercial, managed care contracts, and governmental insurance plans.
  • Strong communication and customer service skills.
Preferred Qualifications
  • Experience with automated systems and business office procedures.
  • Knowledge of third-party payors and medical criteria guidelines.
  • Strong math aptitude and proficiency in PC spreadsheet and database software.


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