Insurance Verification Specialist

7 days ago


Rochester, New York, United States InfuSystem Full time

Job Summary:

The Insurance Verification Specialist will be responsible for verifying patient eligibility and benefits for infusion services. This role requires strong analytical and problem-solving skills to interpret benefit information and identify the correct plan.

Key Responsibilities:

  • Verify patient eligibility and benefits for infusion services
  • Interpret benefit information and identify the correct plan
  • Request authorizations on payer websites, through fax submissions, or over the phone
  • Follow up, document, and re-authorize as necessary
  • Track and follow up on pending authorizations within days depending on payer guidelines
  • Process authorizations electronically using payer portals, fax, or telephone
  • Obtain authorization renewals, verify physician-written orders, and certification of medical necessity
  • Work closely with the customer service team and sales representatives to secure clinical notes and supporting documentation
  • Verify authorization quantities and ensure effective dates are returned and processed correctly by the third-party payers

Requirements:

  • Associate degree or equivalent; two to four years related experience and/or training
  • Organizational skills
  • Medical terminology
  • Good troubleshooting skills
  • Ability to work as a team
  • Ability to independently meet tight deadlines in a project-based atmosphere

Personal and Professional Attributes:

  • Strong work ethic
  • Sound judgment
  • Proven written and verbal communication skills
  • Natural curiosity to pursue issues and increase expertise
  • Courage to promote and defend ideas and analyses
  • Passionate about InfuSystem and serving customers and patients
  • Strives to make an impact on improving business processes and results
  • Exemplary honesty and integrity
  • Ability to collaborate effectively and work selflessly as part of a team


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