Insurance Eligibility Coordinator

2 weeks ago


Austin, Texas, United States Advanced Pain Care Full time
Job Overview

POSITION SUMMARY:

The Insurance Verification Specialist plays a crucial role in managing clerical tasks related to the verification of insurance details. This includes calculating estimated patient responsibilities for services rendered and resolving any insurance-related issues for patients scheduled for care. The specialist will adhere to established policies and procedures throughout the organization.

QUALIFICATIONS:

  • High school diploma with at least 1 year of relevant experience or training, or a suitable combination of education and experience. Experience should encompass understanding of payer eligibility electronic returns and the ability to distinguish between various insurance plans, copayments, deductibles, and coinsurance.
  • Strong problem-solving abilities and sound judgment.
  • Capacity to collaborate across departments and foster effective relationships with both internal and external stakeholders to meet objectives.
  • Familiarity with customer service principles and practices.
  • Aptitude for achieving team objectives while embodying organizational values and utilizing resources efficiently.
  • Proactive approach and initiative in tasks.
  • Attention to detail, accuracy, and quality monitoring in work.
  • Strong organizational capabilities.
  • Excellent verbal and written communication skills, along with exceptional interpersonal abilities.

KEY RESPONSIBILITIES:

  • Become acquainted with the insurance carriers contracted with Advanced Pain Care.
  • Conduct phone communications with patients, their families, insurance companies, and facility personnel to gather necessary verification information.
  • Maintain accurate patient demographic data and collection systems.
  • Verify insurance eligibility for upcoming appointments using online resources or direct communication with carriers.
  • Review patient deductibles and copayments, entering relevant information into the billing system utilized by front-end staff across all locations.
  • Assist front-end and call center staff in navigating carrier websites and verifying eligibility.
  • Respond to inquiries from patients, clerical staff, and insurance representatives.
  • Perform additional job-related duties as assigned.
  • Uphold the highest standards of confidentiality; comply with all HIPAA regulations and adhere to Advanced Pain Care policies and procedures.

WORKING RELATIONSHIPS:

Reports directly to the Director of Patient Access.

WORK ENVIRONMENT:

Environmental Conditions:

  • Medical office setting.

Physical Requirements:

  • Ability to work as scheduled.
  • Capability to sit and/or stand for extended periods.
  • Tasks may involve moving materials weighing up to 30 lbs.
  • Required eye-hand coordination and manual dexterity to operate office equipment.


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