Insurance Verification Specialist

About This Role

The Insurance Verification Specialist is crucial for ensuring patients' insurance coverage is confirmed for evaluations and surgeries, including verifying in-network status, deductibles, co-pays, and coinsurance. This role also involves providing financial estimates to patients and managing prior authorizations to facilitate seamless patient care and revenue functions.

Responsibilities

• Verify insurance coverage prior to patient arrival for evaluation
• Determine if the surgery center is in or out of network for patients
• Complete insurance verification forms with correct benefit information, including deductible, co-pay and/or coinsurance
• Provide estimates to patients on financial responsibility
• Generate daily reports of evaluations to verify insurance is within network
• Obtain referrals and prior authorizations from policies that require it
• Answer patient phone calls promptly and address patient concerns
• Obtain proper insurance information and provide insurance information to patients
• Serve as a backup for registration and scheduling
• Protect patient’s confidentiality by securing protected health information and logging off computers
• Answer the phone while maintaining a polite, consistent phone manner using proper telephone etiquette
• Obtain revenue by recording and updating financial information, collecting patient charges, controlling credit, and expediting third-party claims

Requirements

• Working knowledge of insurance verification, benefits, prior authorization, medical necessity, and coordination of benefits
• Ability to pay attention to details and accurately input data
• Knowledge of medical terminology
• Proficiency in Word, Excel, Outlook
• Good PC and telephone skills
• Strong customer service skills
• Time management and organization skills
• Attention to detail
• Ability to multi-task
• Flexibility
• Professionalism

Qualifications

• High school diploma and or equivalent

Skills

* Required skills