Healthcare Insurance Verification Specialist

4 weeks ago

Spring Valley, Nevada, United States Catholic Health Initiatives Full time
Job Summary

As a Healthcare Insurance Verification Specialist at Catholic Health Initiatives, you will play a critical role in ensuring that patients receive the necessary care while minimizing financial burdens. Your primary responsibility will be to verify patients' insurance information and obtain authorization prior to scheduled visits, adhering to HIPAA guidelines and internal standards.

Key Responsibilities

1. Verify patients' insurance coverage by telephone and resolve any issues that may arise.
2. Interpret coverage limitations and patient versus insurance coverage, following up with payors/patients to secure accounts and respond to insurance verification questions.
3. Work closely with physicians, patients, and other healthcare staff to ensure authorizations cover the necessary services and correct information is obtained.
4. Coordinate with clinical staff to obtain charge information for all patients and code procedures performed and diagnosis on charge.
5. Assign appropriate ICD-9, CPT, and HCPCS codes to accurately support the need and documentation for each service.
6. Coordinate copies of medical documentation with physician charges to support billing to third-party payers.
7. Identify physician services provided but not accurately documented in the medical record.
8. Resolve routine patient billing inquiries and problems.

Requirements

* Bachelor's degree in a related field is preferred.
* 2-4 years of healthcare experience is preferred.
* Thorough understanding of insurance payor reimbursement, collection practices, and accounts receivable follow-up is required.
* Broad knowledge of HIPAA, federal, and state regulations is required.
* Understanding of insurance payor reimbursement and collection practices is required.
* Knowledge of insurance industry and basic medical terminology/abbreviations is preferred.
* Strong customer service skills and good communication skills are required.

Compensation

$13.22 - $18.17/hour

Catholic Health Initiatives is an equal opportunity/affirmative action employer.

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