Insurance Verifications Specialist

Position Overview

Ultimate Staffing Services is actively seeking an experienced Insurance Verification Specialist to join their client's team in Florida. This role is crucial for ensuring the accuracy of insurance verification for clinic and outpatient surgery appointments, as well as counseling patients regarding their financial obligations for procedures. The ideal candidate will thrive in a team environment and possess a strong customer service focus to effectively interact with patients, doctors, staff, and management.

Responsibilities

• Verify insurance for clinic and outpatient surgery appointments.
• Counsel patients on their financial cost share for procedures and collect payments prior to procedures.
• Ensure a solid understanding of medical insurance including deductibles, copay, and coinsurance.
• Verify and interpret medical benefits for Medicare, Medicaid, and major commercial health insurance and secondary payers.
• Process provider referrals and prior authorization requests.
• Understand medical terminology and ICD-10 codes and Diagnosis.
• Verify patient eligibility via payer websites or telephone to determine coverage of benefits and calculate patient responsibility for scheduled services.
• Add or update patient insurance information in the EHR system.
• Communicate with insurance companies via phone and/or website to provide any supporting clinical documentation needed for authorization processes.
• Ensure complete and accurate information is maintained in patient accounts, including authorization or referral received from payer or Primary Care Physician.
• Possess strong people skills, being diplomatic, patient, and flexible, while being able to multitask and be cross-trained on all functions within the Insurance Verification Department.
• Perform general duties and other functions as required or assigned.
• Possess a working knowledge of Microsoft Suite including Excel, Word, and Outlook.

Qualifications

• High level of proficiency in verifying and interpreting medical benefits.
• Experience in processing provider referrals and prior authorization requests.
• Knowledge of medical terminology and ICD-10 codes preferred.
• Ability to verify patient eligibility and maintain accurate patient records.
• Strong communication and interpersonal skills.
• Ability to multitask and adapt to different situations.
• Proficiency in Microsoft Office Suite.
• Ability to be mobile in an office setting, including sitting, standing, walking, and bending.

Required Work Hours

Monday - Friday, First Shift

Benefits

The position offers competitive compensation with a pay range of $19 to $24 per hour.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance.