Insurance Eligibility Coordinator

1 week ago

West End, United States Pinehurst Medical Full time
Job Overview

Pinehurst Medical Clinic (PMC)

Pinehurst Medical Clinic is a well-established healthcare provider serving the communities across Moore County, Lee County, Cumberland County, Chatham County, and the surrounding areas. As a locally owned entity, PMC delivers a comprehensive range of primary and specialty care services. Our dedicated team of physicians and healthcare professionals is committed to providing patient-centered care that leverages the latest advancements in medical technology. Since our inception in 1952, we have been recognized for our blend of innovative medical practices and genuine compassion for our patients. PMC comprises over 130 healthcare providers, approximately 750 staff members, and operates across 16 locations.

Employee Benefits

At PMC, we prioritize the overall health and well-being of our employees, ensuring they can excel both personally and professionally. As part of our team, you will receive a comprehensive benefits package designed to support your health, family, and future aspirations. For more details about our benefits, please refer to our informational resources.

Role of the Insurance Verification Specialist

As an Insurance Verification Specialist, your primary responsibilities will include reviewing, confirming, and updating payer information prior to the pre-certification process. You will also assess insurance eligibility and identify the appropriate payer for patients on the date of service. Additionally, you will be tasked with updating insurance details, verification dates, and relevant comments in our system.

Typical Responsibilities
  • Proactively review eligibility information from payers in our system for all services requiring pre-certifications.
  • Analyze payer coverage against the date of service for all pre-certification-required services.
  • Utilize payer websites to verify the correct payer for the date of service.
  • Update and confirm accurate information in our system by completing necessary fields, such as verification dates.
  • Provide training to colleagues as needed to ensure smooth operations during busy periods or employee absences.
  • Participate in meetings and professional development opportunities as required.
  • Carry out additional duties as assigned.
Qualifications

Required:

  • High school diploma or equivalent; or one to three months of related experience and/or training; or a combination of education and experience.

Preferred:

  • Experience in data entry operations.
  • Attention to detail with a strong financial focus.
  • Previous experience in a medical office setting; insurance processing experience is highly desirable.

Work Schedule: Day Shift (Monday through Friday) with no weekends or holidays.

Compensation: Hourly (Non-Exempt)

Pinehurst Medical Clinic is an equal opportunity employer and adheres to all state, federal, and local regulations, providing equal employment opportunities to all individuals regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by law.

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