Insurance Verification Specialist
2 weeks ago
Top reasons to work for SMA Healthcare:
- Career growth and advancement potential
- Great benefits such as: Health, Dental, Vision, Life, & Disability Insurance
- Tuition Reimbursement
- Paid Personal Leave and Paid Holidays
- 403b Retirement Plan (matches one to one of employee contribution for the first 3%, then a 50% match on the next 6% of employee contribution)
- Collect demographic and insurance data, verify insurance eligibility and benefits via computer portal systems and via telephone for commercial insurance providers, and enter financial eligibility and authorization data in SMA's EMR system.
- Run client face sheets daily for various SMA Healthcare Outpatient programs and sites as assigned.
- Notify SMA staff of insurance authorizations and insurance company expectations through email and/or phone calls.
- Notify SMA staff of co-pay/co-insurance/deductible information for the purposes of collection of client financial responsibility.
- Acts as liaison between SMA staff and insurance companies, funding sources, or their managed care organizations when client's health care is being managed under a managed care plan.
- Reviews Managed Care Report for services needing continued authorization and processes completed requests to managed care company to obtain continued authorization.
- Update authorization spreadsheet and update EMR authorization determination record to include: services authorized, units or visits, effective and end date, provider when applicable and the authorization number.
- Review Financial Assessments when required by program, and approve and add payer if client meets eligibility requirements.
- If required by specific program, review Specialty Reports and DCF Program Client Lists, update client Credible record to reflect payer changes, keep each assigned DCF Program binder current and complete a client insurance report for each assigned DCF Program.
- Additional duties may be required as per specific program guidelines.
Minimum Education and/or Experience: High school Diploma and one year of Insurance Verification and/or behavioral health experience. Experience in a setting where it was necessary to communicate orally and in writing to inform, advise, or train others about treatment service delivery, client record documentation, or Insurance Verification preferred. Experience with American Society of Addictions Medicine Patient Placement Criteria is preferred. Experience with CARF, Medicaid, and Managed Care requirements is preferred.
Knowledge/Skills/and Abilities:
- Demonstrates proficiency with assigned client populations in performing Insurance Verification including extensive telephonic communication skills with insurance providers.
- Ability to maintain professional working relationships with insurance representatives, clinical staff, and stakeholders.
- Experience with Electronic Medical Records (EMR).
Necessary Special Requirements: Possession of a valid Florida driver's license, acceptable driving record, and proof of personal automobile insurance if required to drive an SMA vehicle and/or use a personal vehicle for SMA business. Complete State of Florida mandatory background screening prior to start of employment. Complete SMA required training during the first six (6) months of employment and updated if required.
Physical: Mobility and ability to bend and reach during an 8-12 hour day. Able to lift minimum 10 pounds. Visual and auditory acuity sufficient to evaluate, intervene, treat, and record client health care needs. Fine motor skills for legible and accurate charting, daily correspondence and presentation, either manually or orally. Work endurance ability to work 8-12 hour shifts with a meal break, as possible. Routine 8-12 hour shifts. Hours and days off may vary. Extra hours may be required. Work assignment locations may vary.
Application:This class specification is intended to identify the class and illustrate the kinds of duties that may be assigned to its incumbents. It should not be interpreted as describing all of the duties whose performance may ever be required of such an employee or be used to limit the nature and extent of assignments such individuals may be given.
-
Health Insurance Verification Specialist
2 weeks ago
Deerfield Beach, FL, United States Get Me Healthcare Full timeAre you the type who catches every detail others miss? Do you thrive in fast-paced environments where precision matters? Get Me Healthcare in Deerfield,FL, is hiring a full-time Verification Specialist, and we're looking for someone just like you. If you're ready to play a vital role in ensuring the accuracy and integrity of health insurance applications,...
-
Health Insurance Verification Specialist
1 week ago
Deerfield Beach, FL, United States Get Me Healthcare Full timeAre you the type who catches every detail others miss? Do you thrive in fast-paced environments where precision matters? Get Me Healthcare in Deerfield,FL, is hiring a full-time Verification Specialist, and we're looking for someone just like you. If you're ready to play a vital role in ensuring the accuracy and integrity of health insurance applications,...
-
Health Insurance Verification Specialist
2 weeks ago
Deerfield Beach, FL, United States Get Me Healthcare Full timeAre you the type who catches every detail others miss? Do you thrive in fast-paced environments where precision matters? Get Me Healthcare in Deerfield,FL, is hiring a full-time Verification Specialist, and we're looking for someone just like you. If you're ready to play a vital role in ensuring the accuracy and integrity of health insurance applications,...
-
Insurance Verification/Referral Specialist
6 days ago
West Palm Beach, FL, United States Cancer Center of South Florida Full timePOSITION SUMMARY: The Insurance Verification/Referral Specialist ensures timely and accurate patient care by verifying insurance coverage and obtaining required referrals prior to services being rendered. This role demands a strong understanding of insurance processes and effective communication skills to inform patients of their financial responsibilities...
-
Patient Insurance Verification Specialist
1 week ago
Delray Beach, FL, United States Greenbrook TMS NeuroHealth Centers Full timeAbout Us Neuronetics, Inc. is a leading mental health company dedicated to transforming lives through innovative treatments. Now joined with Greenbrook Mental Wellness Centers, we offer FDA-cleared NeuroStar® TMS and Spravato® therapies for major depressive disorder and treatment-resistant depression across 95+ clinics nationwide. Together, we're expanding...
-
Patient Insurance Verification Specialist
5 days ago
Delray Beach, FL, United States Greenbrook TMS NeuroHealth Centers Full timeAbout Us Neuronetics, Inc. is a leading mental health company dedicated to transforming lives through innovative treatments. Now joined with Greenbrook Mental Wellness Centers, we offer FDA-cleared NeuroStar® TMS and Spravato® therapies for major depressive disorder and treatment-resistant depression across 95+ clinics nationwide. Together, we're expanding...
-
Delray Beach, FL, United States Greenbrook TMS NeuroHealth Centers Full timeAbout Us Neuronetics, Inc. is a leading mental health company dedicated to transforming lives through innovative treatments. Now joined with Greenbrook Mental Wellness Centers, we offer FDA-cleared NeuroStar® TMS and Spravato® therapies for major depressive disorder and treatment-resistant depression across 95+ clinics nationwide. Together, we're expanding...
-
Insurance Verification Specialist
2 weeks ago
Fort Walton Beach, FL, United States Orthopaedic Associates Full timeEnsures that claims process accurately, efficiently and swiftly while being an advocate for the patient and practice. This position is critical in helping collect patient payments more accurately while also making sure that claims are sent to the correct insurance company/address. Responsibilities: * Verifying patient eligibility, multiple health plan...
-
Insurance Verification Specialist
2 weeks ago
Fort Walton Beach, FL, United States Orthopaedic Associates Full timeEnsures that claims process accurately, efficiently and swiftly while being an advocate for the patient and practice.This position is critical in helping collect patient payments more accurately while also making sure that claims are sent to the correct insurance company/address. Responsibilities Verifying patient eligibility, multiple health plan benefits,...
-
Health Insurance Policy Verification Analyst
14 hours ago
Deerfield Beach, FL, United States Get Me Healthcare Full timeAre you detail-oriented, organized, and ready to make a difference? Get Me Healthcare, located in Deerfield, FL, is looking for a full-time Health Insurance Policy Verification Analyst to join our growing team! In this exciting role, you'll be the final checkpoint ensuring the accuracy and compliance of health insurance applications. If you enjoy working in...
