Insurance Eligibility Specialist
1 week ago
Rezolut is looking for an Insurance Verification Representative to enhance our operational efficiency.
Position Summary
The Insurance Verification Representative will undertake administrative responsibilities related to patient billing, which includes confirming insurance details, obtaining prior authorizations, and addressing issues to facilitate a seamless billing experience.
Key Responsibilities
- Maintain accurate patient demographic records and data management systems.
- Confirm insurance eligibility for medical plans, Workers Compensation, and No Fault for scheduled appointments by utilizing online resources or direct communication with insurance providers.
- Collaborate with referring physician offices, medical insurers, Workers Compensation, and No-Fault insurance to secure prior authorizations for imaging services.
- Assess patient deductibles and copayments, entering this information into the billing system and relevant spreadsheets for the front-end department.
- Coordinate with front-end teams to rectify scheduling discrepancies.
- Support front-end staff and call center representatives with insurance verification and eligibility checks.
- Work alongside colleagues to ensure accurate billing practices.
- Engage with the Billing Company to address coding discrepancies.
- Input insurance referrals as necessary.
- Contribute to the development of organizational procedures and update documentation as needed.
- Respond to inquiries from patients, administrative staff, and insurance representatives.
- Participate in training initiatives and attend team meetings.
- Assist in formulating and disseminating standard operating procedures to enhance process accuracy and clarity.
- Follow up on accounts requiring additional review.
- Uphold strict confidentiality and comply with HIPAA regulations.
Required Skills and Competencies
- Exceptional written and verbal communication abilities.
- Strong organizational capabilities.
- Proactive mindset with a willingness to take 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.
- Capacity to work independently as well as collaboratively.
- Proficient computer skills.
- Dedication to quality patient care and outstanding customer service.
- Ability to build and maintain effective working 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 to advance your career.
Work Schedule
- Full-time, Monday to Friday from 9 AM to 5:30 PM.
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