Insurance Verification Specialist

Job Description

· Enter data and validate patient information.

· Researches and corrects invalid or incorrect patient demographic information such as invalid insurance policy number to ensure proper billing.

· Verifies participating status of providers.

· Determines member benefit coverage.

· Monitor and verify insurance information for individual patient visits and procedures.

· Communicate with patients about co-pays, benefits, coverage, and care authorization.

· Contacts providers with authorization, denial, and appeals process information.

· Assists in educating and acts as a resource to scheduling department.

· Works and assists with the billing department in researching and resolving rejected, incorrectly paid, and denied claims as requested.

· Responds professionally to all inquiries from patients, staff, and payorin a timely manner.

· Accurately documents patient accounts of all actions taken.

Qualifications

· High School Diploma or GED

· Demonstrated knowledge of insurances

Additional Information

In accordance with HIPAA, this position must maintain the confidentiality of the patient in all circumstances as well as company confidentiality. Ensures the confidentiality of data collected and stored is maintained.

This description is intended to provide basic guidelines for meeting job requirements. Responsibilities, knowledge, skills abilities, and working conditions may change as needs evolve.

The Center provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws.

The Center complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities.