Insurance Verification Specialist

About This Role

This role is responsible for completing patient accounts by verifying insurance eligibility, benefits, and ensuring all required notifications and authorizations are completed. The specialist will communicate with various internal and external stakeholders to ensure timely verification and accurate reimbursement for patient services.

Responsibilities

• Complete patient accounts by verifying eligibility and benefits
• Ensure all notifications and authorizations are completed within the required timeframe
• Communicate timely with Pre Access, Utilization Review, Financial Counselors, and Physician Offices
• Document systems according to Insurance Verification guidelines for accurate and timely reimbursement
• Utilize tools such as Trace, OneSource, Web Portals to complete verifications, precertifications, and notifications
• Log into Avaya System and phone queue
• Stay abreast of and comply with applicable regulations, department and/or system policies and procedures
• Adhere to payer guidelines by plan and service type

Requirements

• High School Diploma or Equivalent
• 1 year experience in a business office in healthcare environment/patient access in hospital setting/call center in healthcare environment/Revenue Cycle experience in healthcare
• Ability to consistently meet performance standards of production, accuracy, performing due diligence and quality
• Good listening and communication skills
• Professional telephone etiquette
• Ability to manage multiple, changing priorities in an effective and organized manner
• Excellent data entry, numeric, typing and computer navigational skills
• Basic computer skills and Microsoft Office

Qualifications

• High School Diploma or Equivalent
• 1+ year experience in a business office in healthcare environment, patient access in hospital setting, call center in healthcare environment, or Revenue Cycle experience in healthcare

Nice to Have

• Working knowledge of Medical Terminology
• Insurance verification knowledge

Skills

* Required skills

Benefits

Certifications