Medical Insurance/Eligibility/Financial Specialist

Insurance Specialist

The Insurance Specialist verifies benefits and obtains authorizations for all exams scheduled in an efficient and timely manner while maintaining a high level of customer service. Administration of the insurance process includes verifying insurance and obtaining appropriate authorizations to ensure quality patient care and satisfaction.

Job Responsibilities:

• Obtains authorization/pre-certification for the correct scheduled exams of assigned facility.
• Effectively uses task work list and inputs insurance benefits and authorizations in the proper context and location.
• Maintains/updates current insurance authorization requirements. When changes are made, insurance requirement list is distributed appropriately.
• Receives internal and external telephone calls to answer questions and resolve problems regarding insurance benefits, verifications, and/or authorizations in a concise and courteous manner.
• Effectively communicates benefits and authorization/precertification problems to the referring physician, patient, and/or RIS facility as needed.
• Schedules and reschedules patient appointments when needed from the scheduling phone queue or incoming phone calls.
• Maintains patient confidentiality and complies with HIPAA guidelines.
• Performs related work as required.
• Customer Service.

Work Experience/Educational Requirements:

• 2 or more years in the Medical Insurance Field preferred.
• High school diploma or GED.

Skills/Physical Requirements:

• Skills in establishing and maintaining effective working relationships with staff, patients and referring physician offices, and the ability to work independently.
• This job requires prolonged sitting; normal vision range with the absence of color blindness, normal hearing, and normal eye to hand coordination and manual dexterity; the ability to distinguish letters and symbols. This position may require lifting up to 25 pounds.

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