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Medical Insurance Verification Specialist

1 month ago

New Hyde Park, New York, United States Manhattan Restorative Health Sciences Full time
Job Overview

As a Verification Specialist, you will play a crucial role in ensuring the accuracy and efficiency of medical insurance verifications and authorizations at Manhattan Restorative Health Sciences (MRHS).

Our team of world-class physicians and specialists is dedicated to developing innovative treatment plans for our patients and advancing impactful medical research. We are seeking a detail-oriented and organized individual to join our team and contribute to our mission.

Key Responsibilities

• Verify and pre-authorize major medical insurances, workman's comp, and no-fault cases
• Obtain proper insurance information, insurance cards, and identification
• Update patient folders and charts with detailed and accurate information, including in- and out-of-network coverage
• Practice confidentiality and privacy protocols in accordance with Office policies and HIPAA requirements
• Coordinate with authorization and billing departments to ensure accuracy and efficiency in all related processes
• Identify appointments and procedures for assigned departments that require authorization by monitoring schedules, system reports, and dashboards
• Identify referral and authorization requirements of patients' insurance plans by using various online resources according to department workflows
• Verify insurance eligibility and benefits and update patient insurance information as necessary
• Complete referrals and prior authorizations in a timely manner according to department guidelines and workflows
• Ensure that appropriate and accurate information is entered into the patient account
• Respond timely and collaborate effectively with Reimbursement Department teams to limit denials and ensure proper reimbursement
• Collaborate with team members to meet department deadlines and benchmarks

Requirements

• 2+ years of experience with medical verifications and authorizations
• Knowledge of insurance carrier guidelines, clinical policies, and state guidelines pertaining to referrals and prior authorization
• Workman's comp, no-fault, and major medical insurance experience required
• Demonstrate complete system knowledge, ability to run reports, document and manage referrals and authorizations, move correspondence, resolve eligibility and authorization holds, and other system tasks within user's security access
• Demonstrate the ability to request, prepare, and recognize documentation required to support medical necessity for service being authorized
• Demonstrate the ability to use electronic tools and systems available to organize and process daily work
• Possess excellent interpersonal skills, outgoing and personable
• Ability to thrive in a fast-paced environment
• Excellent written and verbal communication skills
• Methodical and detail-oriented
• Pleasant and personable telephone demeanor
• Well-spoken and written English

All qualified applicants will receive consideration for employment without regard to age, sex, sexual orientation, gender identity, national origin, race, color, religion, disability, or protected veteran status, or any other legally protected basis, in accordance with applicable laws. For more information, visit MRHSclinics.com