Insurance Verification Specialist

Role Overview

• Responsible for determining patient’s primary, secondary and tertiary insurance payer.
• Verify patients’ benefits, eligibility, and seek authorization for services by contacting insurance companies.
• Determine patient financial impact, if any, and inform them of any possible financial responsibility.
• Responsible for the timely verification of medical insurance benefits for new patients, existing patients with changes in insurance, and reactivated patients.
• Review and update patient accounts with insurance policy information and process requests accurately.
• Notate each account with a clear summary of patient eligibility and insurance benefits received from the carrier.
• Call government funded and commercial insurance companies to obtain prior authorizations or referrals.
• Determine the correct Coordination of Benefits.
• Complete verification requests confirming the correct network status through the company’s contracts with insurance payers to determine member benefit coverage.
• Ensure all insurance, demographic and eligibility information is obtained, and entered in the system in an accurate manner.
• Responsible for reviewing customer files for missing insurance information required to bill for services rendered.
• Perform financial review on existing accounts to identify benefit issues.
• Assist in maintaining inbound faxes, manuals, logs, and other documentation as required.
• Complete insurance verification and summary of reimbursement, and liability forms.
• Advise the Manager of verification trends and updates.
• Meets individual, departmental, and company goals.
• Occasionally engage in overtime if recognized as high performer.

Requirements

• High school diploma.
• Medical terminology.
• Two years’ experience in medical insurance plans or benefit verification practices.
• Excellent written and verbal communication skills.
• Ability to read and understand explanations of medical benefits.

Benefits

• Comprehensive medical, dental, and vision insurance plans to keep you and your family healthy.
• Access to company sponsored wellness programs and mental health resources.
• Paid leave of absence for qualifying events.
• Generous paid parental leave for both birthing and non-birthing parents.
• A competitive 401(k) plan with company match that vest immediately.
• Financial planning services to help you secure your future.
• Corporate discount programs for goods and services.
• Generous paid time off.
• Flexible work hours.
• Flexible work arrangement options to help you balance your personal and professional life may be available.
• Opportunities for continuous learning and career advancement through training programs, mentorship, and tuition reimbursement.
• Recognition programs to celebrate achievements and contributions, including peer recognition, bonuses, awards, and special events.
• A supportive work environment where everyone feels valued, and has a sense of belonging.
• Participate in team-building activities, volunteer opportunities, and company-sponsored events.