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Insurance Eligibility Specialist
2 months ago
Rezolut is seeking a dedicated Insurance Verification Representative to enhance our operational efficiency.
Role Summary
The Insurance Verification Representative is responsible for executing administrative tasks related to patient billing, which includes confirming insurance details, securing prior authorizations, and addressing any issues to facilitate a seamless billing experience.
Key Responsibilities
- Maintain accurate patient demographic records and data management systems.
- Confirm insurance eligibility for various medical plans, including Workers Compensation and No Fault, for scheduled appointments by utilizing online resources or direct communication with insurance providers.
- Collaborate with referring physician offices and insurance companies to secure prior authorizations for imaging services.
- Assess patient deductibles and copayments, entering relevant information into the billing system and spreadsheets for the front-end team.
- Coordinate with front-end staff to rectify scheduling discrepancies.
- Support front-end and call center personnel with insurance verification processes.
- Work collaboratively with team members to ensure accurate billing practices.
- Engage with the Billing Company to address any coding discrepancies.
- Input insurance referrals as necessary.
- Contribute to the development of organizational procedures and the updating of documentation.
- Respond to inquiries from patients, administrative staff, and insurance representatives.
- Participate in training sessions and attend team meetings.
- Assist in formulating and disseminating standard operating procedures to enhance process accuracy and comprehension.
- Follow up on accounts requiring additional review.
- Uphold strict confidentiality and comply with HIPAA regulations.
Required Skills and Qualifications
- Exceptional written and verbal communication abilities.
- Strong organizational capabilities.
- Proactive mindset with a strong initiative.
- Customer-focused approach.
- Meticulous attention to detail.
- Familiarity with CPT and ICD10 coding.
- Able to thrive in a fast-paced environment with high call volumes.
- Knowledge of insurance websites.
- Ability to work independently as well as collaboratively.
- Proficient computer skills.
- Commitment to delivering quality patient care and outstanding customer service.
- Strong interpersonal skills to foster effective relationships with colleagues, radiologists, referring physicians, and patients.
Qualifications
- High School diploma or equivalent.
- A minimum of one year of experience in insurance verification, prior authorization, and billing is required.
Benefits
- Accrue paid time off as you work (Full Time).
- Six observed holidays.
- Comprehensive medical, dental, vision, life, and other voluntary insurance options for full-time employees.
- 401(k) retirement plan.
- Employee Assistance Program.
- Access to Rezolut University, a career development program.
Work Schedule
- Full-time, Monday to Friday from 9 AM to 5:30 PM.
