Insurance Verification Specialist
7 days ago
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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