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Insurance Coverage Specialist
2 months ago
The Insurance Verification & Authorization role is essential for confirming all commercial insurance coverage and assessing patient financial responsibilities. This position involves both electronic and telephonic communication methods to gather necessary information. Accurate and clear entry of all insurance details into the medical records system is a critical function. The ideal candidate will demonstrate strong problem-solving abilities and a willingness to collaborate across various business operations.
Key Responsibilities- Review patient cases and insurance details to tailor communication effectively.
- Manage emotionally sensitive situations with professionalism and empathy.
- Select appropriate internal software insurance codes based on patient insurance information.
- Analyze scanned requisition records to extract and input relevant insurance data.
- Collect and verify patient demographic information during service registration, identifying and addressing any missing data to prevent claim issues.
- Engage with the ordering physician's office or customer service to resolve discrepancies in patient records.
- Ensure prompt processing of benefit information and escalate issues to management as needed.
- Collaborate with team members and contribute ideas during meetings.
- Maintain availability of inpatient files for daily insurance benefit verification and authorization.
- Exhibit self-motivation and the ability to work independently.
- Deliver exceptional customer service by adhering to scheduled shifts and arriving punctually.
- Demonstrate excellent communication and organizational skills.
Perform other related tasks as assigned to ensure the efficient operation of the department.
QualificationsEducation: High School Diploma or equivalent required.
Experience: Prior experience in insurance verification and authorization is necessary.
Skills: Proficiency in typing and operating a PC, along with a solid understanding of medical terminology.
Physical RequirementsThis position requires the employee to sit for extended periods, use hands for various tasks, reach with arms, and communicate effectively. Occasional standing and walking may be necessary, along with the ability to lift or move up to 10 pounds. Specific vision capabilities include close vision, distance vision, depth perception, and the ability to adjust focus. The role is conducted in a professional office environment utilizing standard office equipment such as computers, phones, photocopiers, and fax machines.
