Insurance Benefits Specialist

2 weeks ago

Oklahoma City, Oklahoma, United States Cardiovascular Health Clinic Full time
Job Overview

The Cardiovascular Health Clinic is a dynamic and expanding heart and vascular facility, currently seeking an Insurance Verification Specialist. In this role, you will thrive in a fast-paced environment where your expertise, professionalism, and teamwork will be essential. If you are a meticulous and organized individual eager to contribute positively to a healthcare setting, this position is ideal for you.

Key Responsibilities:

  • Confirm patient insurance benefits
  • Clarify insurance coverage and associated treatment costs, identifying the necessity for any pre-authorizations
  • Collaborate with payers to secure required pre-authorizations
  • Inform patients about coverage, limitations, exclusions, co-insurance, deductibles, and special program requirements
  • Communicate coverage details through electronic means, phone, and in-person interactions
  • Assess patient responsibility amounts prior to related procedures
  • Act as a Patient Advocate for individuals facing challenges with their insurance providers
  • Update management on pre-authorization requirements and any changes
  • Maintain patient accounts, ensuring accurate verification of insurance coverage and updates to patient information with proper documentation
  • Handle a high volume of telephone inquiries professionally, resolving and following up on all issues within set timeframes
  • Achieve positional metrics and benchmarks
  • Uphold the highest ethical standards when managing patient payments and billing processes
  • Adhere strictly to departmental standard operating procedures
  • Perform additional duties as assigned

Required Qualifications:

  • Minimum of 2 years in benefit verification is strongly preferred
  • At least 2 years of experience with prior authorization submission processes is preferred
  • Strong understanding of insurance benefits and Managed Care policies
  • Excellent written and verbal communication skills; must be a team player
  • Ability to adapt, multitask, and troubleshoot effectively
  • Detail-oriented with exceptional organizational skills
  • Demonstrates outstanding customer service skills and professionalism
  • Familiarity with medical terminology

Remote Work Requirements:

  • Availability to work during scheduled hours, excluding lunch and breaks
  • A quiet, distraction-free workspace
  • Reliable high-speed internet connection
  • Respond to all non-urgent communications within one business day
  • Notify management immediately of any technical or access issues affecting work completion
  • Inform management at least 30 minutes prior to scheduled start time for any unplanned absences

Work Environment:

This role is remote, operating Monday through Friday from 8:00 AM to 5:00 PM, with occasional in-office days for training and meetings.

Physical Requirements:

This position requires a full range of body motion. Duties involve regular sitting, walking, and standing; talking or hearing, both in person and by phone; repetitive use of hands for standard office equipment; reaching with hands and arms; and lifting up to 25 pounds.

Equal Employment Opportunity Statement:

The Cardiovascular Health Clinic provides equal employment opportunities to all employees and applicants, prohibiting discrimination and harassment of any kind based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all employment terms and conditions.

Salary and Benefits:

This is a full-time, non-exempt position offering competitive compensation and a comprehensive benefits package, including 401K, a full suite of medical, dental, and ancillary benefits, paid time off, and more.

The information provided herein is intended to describe the general nature and level of work performed by the Insurance Verification Specialist, but is not an exhaustive list of responsibilities, duties, or skills required. Additional duties may be assigned as business needs arise. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential functions.

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