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Insurance Verification Specialist
POSITION SUMMARY:
The Insurance verification specialist performs clerical functions for patient billing, including verification of insurance information and resolution of problems to ensure a clean billing process. Follows up on accounts that require further evaluation. Works with others in a team environment
ESSENTIAL DUTIES:
The Insurance verification specialist performs clerical functions for patient billing, including verification of insurance information and resolution of problems to ensure a clean billing process. Follows up on accounts that require further evaluation. Works with others in a team environment
ESSENTIAL DUTIES:
- Maintains patient demographic information and data collection systems.
- Verify insurance eligibility for medical insurance for upcoming appointments by utilizing online websites or by contacting the carriers directly.
- Receiving, cataloging, and tracking progress of verification requests received.
- Recognize insurance verifications that need to be transferred to referrals for authorizations.
- Coordinate with front end regarding scheduling errors.
- Assist front end staff and call center staff in understanding carrier websites and verification of eligibility.
- Evaluate insurance for need of a referral.
- Answer questions from patients, clerical staff, and insurance companies.
- Works in conjunction with the front office staff to ensure clean billing.
- Participates in trainings and attends staff meetings.
- Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
- Other duties as assigned.
POSITION REQUIREMENTS:
A.KNOWLEDGE, SKILLS AND ABILITIES:
- Must have thorough knowledge of all insurance procedures to include, but not limited to, registration requirements, collection of co-pays, co-insurances, deductibles, and allowable procedures and charges HPPA laws and regulations.
- Must have knowledge of maintaining health care records.
- Must be computer literate experience preferred.
- Must be able to deal with all patients or visitors regardless of their temperament with proper decorum.
- Must have excellent organizational skills.
- Bilingual (English/Spanish) desired.
- Must know medical terminology.
- Must have excellent verbal and written communication skills.
- Must possess excellent customer service skills.
QUALIFICATIONS:
B. EDUCATION, EXPERIENCE AND SKILLS REQUIRED:
B. EDUCATION, EXPERIENCE AND SKILLS REQUIRED:
- High School Diploma or equivalent
- Minimum of 1-2 years’ experience in administrative medical office setting
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