Insurance Verification

Position : Insurance Verification

Location : Stuart ,FL

Duration : 12 Months Contract

Total Hours/week : 40.00

1st Shift 9:30AM - 6PM W/ OT as needed

Description:

• Good computer skills required with strong Microsoft Office experience. Will be performing alpha and numeric data entry. Candidate should have strong ability to retain verbal information and strong verbal communication skills.
• Previous Call Center experience is a plus, but not required.

Position Purpose

• To verify new patient insurance coverage and to re-verify existing patient insurance coverage for medical supply eligibility and billing purposes

Primary Duties and Responsibilities

• Verification and documentation of new patient insurance coverage and coordinating costs for supplies in order to communicate to the patient and billing what the patient order cost will be
• Re-verification of existing patient insurance coverage to ensure that repeat order cost and eligibility is communicated to the patient and the billing department
• Contact insurance carriers to request any prior authorizations as needed for patients that must seek prior approval before obtaining medical supplies
• Special verification projects for newly contracted insurance plans and audit of any patients that may be impacted
• Verification of insurance coverage through HIPAA and regulatory complaint out bound phone calls or via the providers online portal
• Communication internally with Sales operations or Medical Billing operations of insurance eligibility for each new and existing patient in order to complete the sale or obtain further medical documentation
• Communication externally with patients to explain information received relative to their insurance benefit and how it relates to their medical supply purchase
• Develops and maintains knowledge in medical terminology, billing and insurance guidelines
• Ability to identify and professionally resolve insurance verification related issues
• Track daily production and submit daily log to direct supervisor.

Ancillary Duties and Responsibilities

• Maintain a positive work atmosphere that embodies Liberator’s philosophy- Professional excellence, teamwork and integrity.
• Performs other duties and tasks as assigned

Reporting Relationship Responsibilities

• __x__ No supervisory responsibilities
• __ ___ Provides work direction only
• _____Provides work direction plus has responsibility for hiring, promotions, transfers, performance management, discipline, and discharge.

Minimum Requirements or Qualifications (To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions)

• Education/Experience: High School Diploma or general education degree (GED); one to two years related experience and/or training; or equivalent combination of education and experience.
• Language: Ability to read, analyze, and interpret medical supply publications, technical procedures, and/or training tools. Ability to write internal and external business correspondence. Ability to effectively present information and respond to questions from management, team members, and/or customers.
• Math: Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages. Ability to apply intermediate math skills.
• Reasoning: Ability to solve practical problems and deal with a variety of variables. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Advanced analytical reasoning to include ability to forecast exponentials within work flow processes and reason against outside factors.
• Computer: Knowledge of Microsoft Office Applications, Access or other database software
• Telecommunications: ability to utilize or knowledge of call center telecommunications software
• Licensure or Certifications required: No certifications required
• Production/Quality Metrics: Demonstrate ability to produce one (1) completed insurance verification every 9-11 minutes on average, with an error rate of 3.5% or less each calendar quarter. Production and quality standards are at the sole discretion of management and are subject to revision at any time and without prior written notice.

• Work Requirements
• Ability to work some evening shifts, weekends, and overtime as needed
• Physical Demands (The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.) While performing the duties of this job, the employee is frequently required to walk, sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand. The employee must occasionally lift and/or move up to 10 lbs.
• Work Environment (The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.) While performing the duties of this position, the employee performs tasks in a temperature controlled office environment under normal office conditions. The noise level in the work environment is usually moderate. The work environment involves minimal exposure to hazards or physical risks, which require following basic safety precautions.

Disclaimer

• The above job description is meant to describe the general nature and level of work being performed; it is not intended to be an exhaustive list of all responsibilities, duties, and skills required for this position. The Company officers, mid-level, and entry level management staff may assign additional duties and responsibilities as needed. This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to follow any other job-related duties requested by their supervisor in compliance with Federal and State Laws.