Insurance Verification Specialist

Job Description

Job Description

Job Description

Insurance Verification Specialist - On Site

Job Title: Insurance Verification Specialist

Department: Billing

Immediate Supervisor Title: Billing Supervisor

General Summary: Review each day’s schedule and verify insurance, updating patient and insurance demographics, and ensuring any necessary referrals are in place while following healthcare regulations.

Essential Job Responsibilities:

1. Review current day’s schedule to ensure there are no add ons or any unresolved eligibility issues.
2. The eligibility goal is to stay five days ahead of the current business day
3. Update or correct any insurances that run inactive or unverifiable in the system.
4. Update or correct patient demographics when needed.
5. Verify all Tricare Prime and UHC Medicare Dual Complete HMO plans have active referral on file.
6. Complete any internal tasks, emails, and voicemails in a timely manner.
7. Contact insurance companies, via phone or portal, for network participation and/or patient specific benefits
8. Utilize our patient communication texting service, Klara, as needed
9. Maintain HIPAA compliance and confidentiality standards
10. Ensure office policies and procedures are followed
11. Maintain good communication with patients, coworkers, and supervisors

Education: High School Diploma

Experience: Experience in multi-provider or specialty practice is preferred

Performance Requirements:

Knowledge:

1. Knowledge of medical terminology and insurance processes
2. Experience with Electronic Health Records (EHR) systems

Skills:

1. Written and verbal communication skills.
2. Customer service excellence
3. Basic computer skills.
4. Organizational skills

Abilities:

1. Ability to maintain confidentiality
2. Problem solving abilities

Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.

Work Environment: Position is in a well-lit office environment.

Mental/Physical Requirements: Involves sitting approximately 90 percent of the day, walking or standing the remainder.