PT Med Reception/Ins. Verification Specialist

Insurance Verification Specialist

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.