Medical Insurance Verification/Auth Specialist

Job Description

Job Description

Description:

REMOTE POSITION IN FLORIDA OR EST ONLY!

Join the Team at Florida Spine Associates!

Florida Spine Associates is a premier, multidisciplinary spine specialty private practice specializing in world-class Orthopedic Spine surgery, Interventional Pain Management, and dedicated Physical Therapy. With regional clinics spanning South Florida—including Boca Raton, Boynton Beach, and Delray, West Palm Beach and Fort Lauderdale—our elite team of Board-Certified, fellowship-trained physicians is dedicated to restoring our patients' quality of life using cutting-edge, innovative technologies.

Unlike facility and corporate hospital networks, Florida Spine Associates operates on an agile, independent private practice model, offering deeply personalized, compassionate patient care and clinical autonomy. At Florida Spine Associates, you are a highly valued member of a tight-knit medical team, working in a supportive space where your voice is heard, communication is seamless, and your contributions directly shape our standard of excellence. Experience dedicated growth, team collaboration, work schedules that help promote an efficient work/life balance, and an atmosphere you feel the sense of belonging, opinions/suggestions are valued and not lost in a large organizational environment.

Job Summary: The insurance verification and authorization specialist is responsible for verifying patients' insurance information and coverage eligibility to ensure that healthcare services are covered. They work closely with patients, healthcare providers, and insurance companies to gather and validate insurance details, ensuring accurate billing and reimbursement for medical services rendered.

Key Responsibilities:

Insurance Verification: Verify patients' insurance coverage by obtaining and validating insurance details such as policy numbers, coverage limits, effective dates, and any applicable co-pays or deductibles. Verification includes covered CPT within the patient document verification.

Patient Communication: Communicate with patients to collect necessary insurance information, explain coverage details, and address any queries or concerns related to insurance verification.

Documentation and Record-Keeping: Maintain accurate records of verified insurance information, authorizations, and any communication with insurance companies or patients in electronic health records (EHR) or practice management systems.

Coordination with Healthcare Providers: Collaborate with healthcare providers, medical billing staff, and other relevant personnel to ensure accurate billing and proper documentation of insurance information.

Insurance Authorization: Obtain authorization or pre-certification requirements from insurance companies as required for specific medical procedures, tests, or services.

Resolve Insurance Issues: Investigate and resolve insurance-related issues, including denied claims, coverage discrepancies, or other billing challenges by liaising with insurance representatives or the billing department.

Stay Updated with Insurance Policies: Stay informed about changes in insurance policies, regulations, and procedures to ensure compliance and accurate verification of insurance coverage.

Skills and Qualifications:

• Previous experience in healthcare administration, medical billing, or insurance verification preferred.
• Proficiency in using healthcare software, EHR systems, and insurance verification tools.
• Strong attention to detail and accuracy in verifying insurance information.
• Excellent communication and interpersonal skills for interacting with patients, insurance companies, and healthcare professionals.
• Ability to multitask, prioritize tasks, and work efficiently in a fast-paced environment.
• Knowledge of medical terminology, coding, and insurance billing practices is advantageous.