Insurance Verification Specialist

Job Summary -

Verifies patient insurance coverage for therapy services and effectively documents benefit information. Subject matter expert in completing the prior authorization process and pre-determination with insurance companies. Able to answer patient questions regarding financial obligations. Oversees charge reconciliation to ensure billing accuracy. Services on the internal denials team and actively researches causes/trends for therapy denials. Works closely with the billing office and coding team to adjust past claims related to coding issues. Reviews relevant data for each of the therapy departments and generates daily, weekly, and monthly reports. Assists with workflow management as it elates to scheduling/chart organization/insurance verification. Communicates effectively with office staff and therapists regarding insurance issues/concerns. Fills in for front office stations in the event of staff shortages.

Regulatory Requirements

• High school graduate or equivalent.
• Prior experience in a medical setting is required.
• Experience with insurance preferred.

Language Skills

• Ability to communicate in English, both verbally and in writing.
• Additional languages preferred.
• Excellent interpersonal skills.

Skills

• Meditech experience is preferred.
• Excel spreadsheet/data analysis skills are required.
• Knowledge of medical terminology is preferred, especially ICD-10 and CPT codes.
• Ability to type 40 words per minute.

Qualifications

• High school graduate or equivalent.
• Prior experience in a medical setting is required.
• Experience with insurance preferred.

Preferred Skills

• Ability to communicate in English, both verbally and in writing.
• Additional languages preferred.
• Excellent interpersonal skills.
• Meditech experience is preferred.
• Excel spreadsheet/data analysis skills are required.
• Knowledge of medical terminology is preferred, especially ICD-10 and CPT codes.
• Ability to type 40 words per minute.