PT Medical Reception/Insurance Verification Specialist

Job Title

General Job Summary: Responsible for performing a variety of clerical duties and responsible for insurance verification for patients with medical or auto insurance as well as authorizations.

Essential Job Functions

• Greets, screens, schedules, and directs patients/visitors to appropriate areas and demonstrates excellence with respect to treating and caring for customers in-person and over the phone.
• Responsible for performing a variety of clerical duties: answers phone calls, takes messages, fax, scan, etc.
• Verify that all forms, test results, and other paperwork are in the electronic health record system according to physician and office protocol.
• Obtain prior authorization for patients and verify all insurance based on patient schedules, practice management systems and insurance websites for non-automated insurances.
• Obtain, verify, and update patient information and provides support services to patients and medical staff.
• Maintain the practice management system.
• Collect payments for services rendered per policy, including copayments and balances on patient accounts.
• Daily drawer balancing.
• Obtain referral from the Primary Care Physician for insurances that require referrals and contact patient regarding missing referrals or inactive insurance coverage.
• Verify auto and liability eligibility with insurance carriers. Ensure all auto and/or liability forms are completed and received and compare with the schedule. Use these forms to record verification information and file in the chart.
• Compliance with HIPAA, OSHA, and safety standards of the organization.
• Performs other duties that may be necessary or in the best interest of the practice.

Requirements

Education/Experience: High school diploma or equivalent. Minimum one year of experience in a customer service position, preferably in a medical practice setting. Previous medical assisting knowledge preferred. CPR/AED and First Aid certification.

Other Requirements: Schedules will change as department needs change, including overtime. Travel as needed.

Performance Requirements

Knowledge: Knowledge and proper use of office equipment. Knowledge of practice management and electronic health records systems. Knowledge of HIPAA regulations. Knowledge of current terminology and anatomy. Knowledge of how to obtain insurance benefits and insurance reimbursement policies.

Skills: Skilled in communicating effectively with providers, staff, patients and vendors. Use of a practice management software system. Accuracy in data entry. Detailed-oriented with excellent investigational/research skills. Excellent organizational and multi-tasking skills. Excellent adaptability skills. Basic math skills.

Abilities: Ability to multi-task and analyze situations to respond appropriately. Ability to use math skills to accurately complete daily balancing and provide accurate change to the patient. Ability to work effectively and deal courteously with patients, staff, and others. Ability to organize work environment and work load to meet needs of the organization. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to accurately examine, understand and enter insurance documents. Ability to work independently with minimal or no supervision.

Equipment Operated: Standard office equipment.

Work Environment: Medical Office.

Mental/Physical Requirements: Sitting about 90% in front of a computer screen. Fast paced high productivity environment.