Insurance Verification Specialist

6 days ago


Miami, Florida, United States Marcos Consulting Group Inc Full time
Job Description

**About Marcos Consulting Group Inc**

We are seeking a highly skilled Insurance Verification Specialist to join our team. As a key member of our operations team, you will play a critical role in ensuring the smooth processing of medical claims.

Key Responsibilities:

  • Conduct thorough insurance verification and authorization validation on scheduled patients to guarantee eligibility and accurate claim submission.
  • Establish and maintain effective communication with payers via telephone and/or online platforms.
  • Request pre-authorization for scheduled procedures, urgent procedures, and imaging services.
  • Accurately document account actions taken for pre-certification purposes.
  • Coordinate peer-to-peer reviews with providers for denied requests.
  • Follow up on pending authorization requests in a timely manner.
  • Collaborate with the patient and/or office to ensure accurate financial responsibility, facilitating the collection of copayments, deductibles, and co-insurance for procedures.

Requirements:

  • Experience with podiatric services is highly desirable.
  • Strong analytical and problem-solving skills.
  • Excellent communication and interpersonal skills.
  • Ability to work in a fast-paced environment and meet deadlines.


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