Insurance Eligibility Coordinator
1 week ago
POSITION SUMMARY:
The Insurance Verification Specialist plays a crucial role in ensuring accurate insurance information is obtained for patients. This position involves clerical tasks such as confirming insurance details, calculating estimated patient costs for services rendered, and resolving any insurance-related issues for patients scheduled for care. The specialist will adhere to established policies and procedures while performing duties across the organization.
REQUIREMENTS:
- A high school diploma along with at least one year of relevant experience or training, or a suitable combination of education and experience. Experience should include familiarity with payer eligibility electronic returns and the ability to distinguish between various insurance plans, copays, deductibles, and coinsurance.
- Strong problem-solving abilities and sound judgment.
- Capacity to collaborate effectively across departments and foster productive relationships with both internal and external stakeholders to meet objectives.
- Understanding of customer service principles and practices.
- Aim to achieve team objectives while embodying organizational values and utilizing resources judiciously.
- Proactive approach and initiative in work responsibilities.
- Attention to detail, accuracy, and thorough monitoring of tasks.
- Strong organizational capabilities.
- Excellent verbal and written communication skills, complemented by outstanding interpersonal abilities.
KEY RESPONSIBILITIES:
- Become familiar with the insurance providers that Advanced Pain Care is contracted with.
- Make phone calls to patients, their families, insurance companies, and facility personnel to gather necessary information for verification.
- Maintain patient demographic records and data collection systems.
- Verify insurance eligibility for upcoming appointments through online resources or direct communication with carriers.
- Review patient deductibles and copays, entering relevant information into the billing system utilized by front-end staff across all locations.
- Assist front-end and call center staff in navigating carrier websites and verifying eligibility.
- Respond to inquiries from patients, clerical staff, and insurance representatives.
- Perform additional job-related tasks as assigned.
- Uphold the highest standards of confidentiality; comply with all HIPAA regulations and Advanced Pain Care policies.
WORKING RELATIONSHIPS:
Direct supervision will be provided by the Director of Patient Access.
WORK ENVIRONMENT:
Environmental Conditions:
- Medical office setting.
Physical Requirements:
- Ability to work as scheduled.
- Capacity to sit and/or stand for extended periods.
- Responsibilities may involve moving materials weighing up to 30 lbs.
- Required eye-hand coordination and manual dexterity to operate office equipment effectively.
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