Insurance Verification Specialist / Specialty Billing Representative

This position is eligible for Mid Atlantic Retina's $1,000 Hiring Incentive! The hired candidate will receive $500 after successful completion of 90 days of employment and $500 after successful completion of 1 year of employment! Available to new hires only- not available to agency hires, internal transfers, or re-hires.

Job Type: Full Time

Benefits: Medical, Dental, Vision, Sick Time, Vacation Time, 7 Paid Holidays and more

Job Description

Specialty Billing is responsible for verifying all benefits as they pertain to specialty drug injections and all the co-pay assistance funds. They are also responsible for following up with accounts receivable for any necessary payer.

Essential Functions

• Verifies all benefits for scheduled injection appointments.
• Evaluates all benefits for patient responsibility and notates accurate collection amounts.
• Obtains all necessary pre-authorizations or pre-determinations for each patient to have treatment with a specialty drug.
• Monitors all assigned schedules for add-ons and changes.
• Assists in general billing AR when needed including but not limited to claims follow up, calls to insurances and anything necessary to obtain payment for all specialty drugs.
• Recognizes, interprets, and evaluates inconsistencies, discrepancies, and inaccuracies in accounts along with system files, and initiates appropriate corrective methods.
• Act as customer service representative in person or by telephone for any patient's questions about their account.
• Maintain up to date billing knowledge of insurance carriers and their clinical policies.
• Works overtime as needed.
• Travels to other MAR locations as needed.
• Performs other duties as assigned.

Competencies

• Problem Solving / Analysis - Creative problem solving within defined acceptable parameters. Identifies and resolves problems in a timely fashion.
• Customer Service- Superior listening skills, professional demeanor, and appropriate firmness.
• Conflict Resolution- Responds promptly to customer needs. Ability to handle difficult patient interactions relative to sensitive billing issues.
• Detail Oriented - Ensure proper procedures, protocols and processes are complied with consistently.
• Strong Interpersonal Skills- Works effectively with patients, employees, and physicians.
• Creative problem solving within defined acceptable parameters.
• Time Management- maintains high volume productivity level for essential functions.
• Ethical Conduct - Maintains confidentiality.

Required Education and Experience

• Medical billing experience preferred.
• Knowledge of benefit investigation including obtaining eligibility information, authorizations, and referrals.
• Experience with CPT codes and ICD-10. Microsoft Office Suite required.