Insurance Verification Specialist

4 months ago

Atlanta, United States Shepherd Center Full time

Shepherd Center, located in Atlanta, Georgia, is a private, not-for-profit hospital specializing in medical treatment, research and rehabilitation for people with spinal cord injury, brain injury, stroke, multiple sclerosis, spine and chronic pain, and other neuromuscular conditions.

Join us in our mission to help people with a temporary or permanent disability, rebuild their lives with hope, independence and dignity, advocating for their full inclusion in all aspects of community life.

At Shepherd Center, you’ll discover a diverse and inclusive environment, enlightened leadership, a culture of teamwork, professionalism and mutual respect. If you are seeking career advancement, continuing education opportunities coupled with a welcoming and fun workplace, competitive compensation and employment benefits, visit our to explore current openings.

The Insurance Verification Specialist plays a key role in the patient financial experience by coordinating insurance and benefits verification, pre-certification, and pre-authorization for patients at Shepherd Center, often handling cases that need quick turnaround. The role is knowledgeable on payer regulations and contracts and serves as a point of contact for peers seeking resolution to questions and/or issues.

JOB RESPONSIBILITIES

The Insurance Verification Specialist performs various duties in order to improve the patient financial experience.

Leads and develops training for new staff members.

Verifies benefits and obtains proper billing address and phone number for carrier.

Identifies and obtains information on liability policies which may be a source of payment, including but not limited to, auto, homeowners, commercial liability policies.

Assigns payer plan codes in organization’s electronic health record system; utilizes knowledge of insurance plans and contracts to identify opportunities to improve payer master file.

Utilizes online systems, phone communication, and other resources to verify eligibility and benefits, determine extent of coverage, and secure pre-authorizations before scheduled appointment date.

Ensures all required clinical documentation is obtained and submitted for timely pre-certification.

Serves as point of contact for addressing account issues, patient concerns, or billing and insurance questions before they are escalated to a supervisor or manager.

REQUIRED MINIMUM EDUCATION

High school diploma or GED required

Associate or Bachelor’s degree preferred in healthcare administration or related field preferred

REQUIRED MINIMUM CERTIFICATION

Certified Healthcare Access Associate (CHAA) certification required

Certified Patient Account Representative (CPAR) certification required

REQUIRED LICENSURE

N/A

REQUIRED MINIMUM EXPERIENCE

Minimum of two years’ professional experience in an outpatient setting, rehabilitation center, or as an external case manager.

Knowledge of Commercial, Managed Care Contracts and Governmental Insurance Plans.

Must understand benefit levels, how they’re applicable to Shepherd Center’s array of services, and convey these to Case Managers and Clinical Managers.

Must understand the concepts around discerning between TPAs, networks, how to determine network status, and coordination of benefits rules as they apply to individual patient’s coverages.

Must understand and effectively coordinate benefit plans’ various provisions for accessing drugs (buy and bill/bagging, etc.), payers’ patient programs, SC charity programs, etcetera regarding high cost drugs’ coverages.

Must interpret and understand medical criteria guidelines within payers’ utilization policies to be certain Shepherd Center has provided all necessary data to obtain authorizations.

Experience in automated systems, overall knowledge of business office procedures and hospital policy, knowledge of third-party payors.

Excellent communication and customer service skills.

Familiar with general office equipment.

REQUIRED MINIMUM SKILLS

Must have a working knowledge of PC spreadsheet and database software.

Strong math aptitude required.

PREFERRED QUALIFICATIONS

PHYSICAL DEMANDS

Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time or exerting up to 15 pounds of force occasionally or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body.

WORKING CONDITIONS

Some potential for exposure to blood and body fluids.

  • Insurance Verification Specialist

    3 days ago

    Atlanta, United States Ascend Medical, Inc. Full time

    Insurance Verification: Verify patient insurance coverage and eligibility prior to appointments. Confirm coverage details, including copayments, deductibles, and coinsurance. Patient Communication: Communicate with patients about their insurance bene Insurance, Verification, Specialist, Patient Care, Healthcare, Processing

  • Insurance Verification Specialist

    1 week ago

    Atlanta, Georgia, United States Ascend Medical, Inc. Full time

    Job Title: Insurance Verification SpecialistAscend Medical, Inc. is seeking a highly skilled Insurance Verification Specialist to join our team. As an Insurance Verification Specialist, you will play a critical role in ensuring that patients receive the necessary medical care while minimizing financial burdens.Key Responsibilities:Verify patient insurance...

  • Insurance Verification Specialist

    4 weeks ago

    Atlanta, Georgia, United States Shepherd Center Full time

    Job Title: Insurance Verification SpecialistShepherd Center is seeking a highly skilled Insurance Verification Specialist to join our team. As a key member of our patient financial experience team, you will play a critical role in ensuring seamless insurance and benefits verification, pre-certification, and pre-authorization for...

  • Insurance Verification Specialist

    2 weeks ago

    Atlanta, Georgia, United States Shepherd Center Full time

    Job SummaryThe Insurance Verification Specialist plays a critical role in the patient financial experience at Shepherd Center. This position is responsible for coordinating insurance and benefits verification, pre-certification, and pre-authorization for patients. The ideal candidate will have a strong understanding of payer regulations and contracts, as...

  • Medical Insurance Verification Specialist

    2 weeks ago

    Atlanta, Georgia, United States CornerStone Staffing Full time

    CornerStone Staffing is seeking a skilled Medical Insurance Verification Specialist to join our team.Job Summary:The Medical Insurance Verification Specialist is responsible for verifying patients' insurance benefits and eligibility, ensuring that all information is documented and communicated to healthcare providers.Key Responsibilities:Confirm patient...

  • Medical Insurance Verification Specialist

    4 weeks ago

    Atlanta, Georgia, United States CornerStone Staffing Full time

    Job OpportunityWe are seeking a skilled Medical Insurance Verification Specialist to join our team at CornerStone Staffing.Job SummaryThe Medical Insurance Verification Specialist will be responsible for verifying patients' insurance benefits and eligibility, ensuring that all information is documented and communicated to healthcare providers.Key...

  • Medical Insurance Verification Specialist

    2 weeks ago

    Atlanta, Georgia, United States CornerStone Staffing Full time

    CornerStone Staffing is seeking a skilled professional to fill an exciting opportunity in the Medical Benefits Industry.The Medical Insurance Verification Specialist is responsible for verifying patients' insurance benefits and eligibility, ensuring that all information is documented and communicated to healthcare providers.This role requires strong...

  • Insurance Verification Coordinator

    1 week ago

    Atlanta, Georgia, United States Ascend Medical, Inc. Full time

    Job SummaryAscend Medical, Inc. is seeking a skilled Insurance Verification Specialist to join our team. As an Insurance Verification Specialist, you will play a critical role in ensuring that patients receive the necessary care while minimizing financial burdens. Your primary responsibility will be to verify patient insurance coverage and eligibility prior...

  • Verification Specialist

    2 weeks ago

    Atlanta, Georgia, United States Zelis Full time

    Job Title: Verification SpecialistWe are seeking a skilled Verification Specialist to join our team at Zelis. As a key member of our operations team, you will play a critical role in ensuring the accuracy and completeness of client information.Key Responsibilities:Verify registration and enrollment requests and forms to ensure all necessary information is...

  • Digital Verification Specialist

    2 weeks ago

    Atlanta, Georgia, United States SUCCESS KOREA Full time

    Job Title: Digital Verification SpecialistCompany: SUCCESS KOREAJob Description:We are seeking a skilled Digital Verification Specialist to join our team in Seoul. As a Digital Verification Specialist, you will be responsible for ensuring the functional behavior of our various CMOS image sensors.Key Responsibilities:* Extract verification objectives from...

  • Verification Specialist

    3 weeks ago

    Atlanta, Georgia, United States Zelis Full time

    Job Title: Verification SpecialistWe are seeking a skilled Verification Specialist to join our team at Zelis. As a key member of our operations team, you will play a critical role in ensuring the accuracy and completeness of registration and enrollment requests.Key Responsibilities:Verify registration and enrollment requests and forms for completeness and...

  • Verification Specialist

    3 weeks ago

    Atlanta, Georgia, United States Zelis Full time

    Job Title: Verification SpecialistWe are seeking a skilled Verification Specialist to join our team at Zelis. As a key member of our operations team, you will play a critical role in ensuring the accuracy and completeness of registration and enrollment requests.Key Responsibilities:Verify registration and enrollment requests and forms for completeness and...

  • Insurance Verification Specialist

    4 weeks ago

    Atlanta, Georgia, United States Shepherd Center Full time

    Job SummaryThe Insurance Verification Specialist plays a crucial role in the patient financial experience at Shepherd Center, a leading provider of medical treatment, research, and rehabilitation services. This position is responsible for coordinating insurance and benefits verification, pre-certification, and pre-authorization for patients, ensuring...

  • Insurance Specialist

    1 month ago

    Atlanta, Georgia, United States Shepherd Center Full time

    Job Title: Insurance Verification SpecialistShepherd Center is seeking a highly skilled Insurance Verification Specialist to join our team. As a key member of our patient financial services team, you will play a critical role in ensuring seamless insurance verification and benefits coordination for our patients.Responsibilities:Verify patient insurance...

  • Verification Specialist

    3 weeks ago

    Atlanta, Georgia, United States Zelis Healthcare Full time

    Job SummaryWe are seeking a skilled Verification Specialist to join our team at Zelis Healthcare. As a key member of our client support team, you will play a critical role in ensuring the accuracy and completeness of client registration and enrollment information.Key ResponsibilitiesVerify registration and enrollment requests and forms for completeness and...

  • Insurance Verification Specialist

    2 months ago

    Atlanta, Georgia, United States Shepherd Center Full time

    Job SummaryThe Insurance Verification Specialist plays a pivotal role in the patient financial experience at Shepherd Center, a leading private, not-for-profit hospital specializing in medical treatment, research, and rehabilitation for individuals with spinal cord injury, brain injury, stroke, multiple sclerosis, spine, and chronic pain, as well as other...

  • Verification Specialist

    2 weeks ago

    Atlanta, Georgia, United States Zelis Full time

    Job SummaryWe are seeking a skilled Verification Specialist to join our team at Zelis. As a key member of our operations team, you will play a critical role in ensuring the accuracy and completeness of client registration and enrollment information.Key ResponsibilitiesVerify registration and enrollment requests and forms to ensure all necessary information...

  • Insurance Specialist

    4 weeks ago

    Atlanta, Georgia, United States Shepherd Center Full time

    Job Title: Insurance Verification SpecialistShepherd Center is seeking a highly skilled Insurance Verification Specialist to join our team. As a key member of our patient financial services team, you will play a critical role in ensuring seamless insurance and benefits verification, pre-certification, and pre-authorization for...

  • Insurance Agent Sales Specialist

    2 weeks ago

    Atlanta, Georgia, United States Haven Insurance Group Full time

    Job OverviewHaven Insurance Group is seeking a highly motivated and organized Insurance Agent Sales Specialist to join our team. As a key member of our sales team, you will be responsible for growing your own book of business within the agency.Key Responsibilities:Prospect and obtain new business on your ownGrow your book of business by working with our...

  • Medical Insurance Benefits Coordinator

    2 weeks ago

    Atlanta, Georgia, United States CornerStone Staffing Full time

    CornerStone Staffing is seeking a skilled professional to fill a Medical Insurance Verification Specialist role.The Medical Insurance Verification Specialist is responsible for verifying patients' insurance benefits and eligibility, ensuring that all information is accurately documented and communicated to healthcare providers.Key Responsibilities:Confirm...