Medical Insurance Specialist

Job Full Description

Job Summary


We are seeking a highly motivated and detail-oriented Medical Insurance Verification Specialist to join our healthcare team. In this vital role, you will be responsible for verifying patient insurance coverage, obtaining prior authorizations, and ensuring accurate processing of medical billing and coding information. Your expertise will help streamline patient care processes, improve reimbursement rates, and uphold the highest standards of clinical confidentiality. If you thrive in a fast-paced environment and have a passion for healthcare administration, this is an excellent opportunity to make a meaningful impact in patient services.

Duties

• Verify patient insurance coverage and benefits using Electronic Health Records (EHR) systems and other medical office software.
• Obtain insurance prior authorization by communicating with managed care organizations and insurance providers to secure approval for procedures and treatments.
• Review and interpret health insurance policies, including understanding CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding systems to ensure accurate billing.
• Maintain compliance with HIPAA (Health Insurance Portability and Accountability Act) regulations to protect patient confidentiality during all verification processes.
• Collaborate with medical staff to confirm coverage details, clarify policy limitations, and resolve coverage issues promptly.
• Manage medical records and ensure proper documentation of insurance verification activities within EMR/EHR systems.
• Provide excellent customer service by addressing patient inquiries related to insurance coverage and billing procedures professionally and efficiently.

Experience

• Proven experience in medical office administration or healthcare support roles with a focus on insurance verification or medical billing.
• Familiarity with health insurance policies, managed care processes, and prior authorization procedures.
• Strong knowledge of medical terminology, CPT coding, ICD coding (ICD-9/ICD-10), and medical records management.
• Proficiency in Microsoft Office Suite (Word, Excel) for documentation and reporting purposes.
• Experience working with Electronic Health Records (EHR) or Electronic Medical Records (EMR) systems is highly preferred.
• Understanding of clinical confidentiality policies such as HIPAA is essential to ensure compliance at all times.
• Excellent communication skills combined with a customer service-oriented approach to assist patients and healthcare providers effectively.

Join us to be part of a dedicated team committed to delivering exceptional healthcare administration while fostering your professional growth!

Eugene, OR
3480
945 Garfield
Eugene, OR 97402