Insurance Verification Specialist

Responsible for determining patient's primary, secondary and tertiary insurance payer; verify patients' benefits, eligibility, and seek authorization for services by contacting insurance companies; determine patient financial impact, if any, and inform them of any possible financial responsibility.


Major Areas of Accountability

• Responsible for the timely verification of medical insurance benefits for new patients, existing patients with changes in insurance, and reactivated patients.
• Review and update patient accounts with insurance policy information and process requests accurately.
• Notate each account with a clear summary of patient eligibility and insurance benefits received from the carrier.
• Call government funded and commercial insurance companies to obtain prior authorizations or referrals.
• Determine the correct Coordination of Benefits.
• Complete verification requests confirming the correct network status through the company's contracts with insurance payers to determine member benefit coverage.
• Ensure all insurance, demographic and eligibility information is obtained, and entered in the system in an accurate manner.
• Responsible for reviewing customer files for missing insurance information required to bill for services rendered.
• Perform financial review on existing accounts to identify benefit issues.
• Assist in maintaining inbound faxes, manuals, logs, and other documentation as required.
• Complete insurance verification and summary of reimbursement, and liability forms.
• Advise the Manager of verification trends and updates.
• Meets individual, departmental, and company goals.
• Occasionally, employees currently recognized as high performers through recent performance evaluations, or employees with current demonstrated productivity leadership compared to other employees on existing metrics may be asked to engage in overtime.
• Comfort Medical employees are required to conduct business to the highest ethical and professional standards; comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies.
• Other job duties as assigned

Basic Qualifications

• High school diploma
• Medical terminology
• Two years' experience in medical insurance plans or benefit verification practices
• Excellent written and verbal communication skills
• Ability to read and understand explanations of medical benefits.
  At Coloplast, we believe in recognizing and rewarding the contributions of our employees. Our total rewards package is designed to support your well-being, foster your professional growth, and ensure a healthy work-life balance. Here is some of what you can expect:
  
  • Health and Wellness : Comprehensive medical, dental, and vision insurance plans to keep you and your family healthy. Plus, access to company sponsored wellness programs and mental health resources, paid leave of absence for qualifying events and generous paid parental leave for both birthing and non-birthing parents.
  • Financial Security: A competitive 401(k) plan with company match that vest immediately, financial planning services to help you secure your future, and corporate discount programs for goods and services.
  • Work-Life Balance: Generous paid time off, flexible work hours, and flexible work arrangement options to help you balance your personal and professional life may be available.
  • Professional Development: Opportunities for continuous learning and career advancement through training programs, mentorship, and tuition reimbursement.
  • Recognition and Rewards: Recognition programs to celebrate achievements and contributions, including peer recognition, bonuses, awards, and special events.
  • Community and Culture: A supportive work environment where everyone feels valued, and has a sense of belonging. Participate in team-building activities, volunteer opportunities, and company-sponsored events. Sustainability strategy that outlines our ambitions for how to run our company in a more sustainable way.
  • Competitive Compensation: The starting hourly rate for this position is $18.28. Hired candidates may be eligible to receive additional compensation for applicable experience and may also be eligible for bonuses and/or incentives. Actual compensation is influenced by a variety of factors including but not limited to skills, experience, qualifications, and geographic location.

Comfort Medical provides an extensive selection of name brand catheter and ostomy supplies to thousands of customers nationwide. Our attention to detail, unmatched customer service, and dedication to helping our customers live happier, healthier lives are just a few of the many reasons we are one of the fastest growing catheter and ostomy supply companies in the nation!

Comfort Medical employees are required to conduct business to the highest ethical and professional standards; comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies.

Comfort Medical is committed to a policy of Equal Employment Opportunity (EEO) which means we employ and promote individuals based on their merits, regardless of race, color, religion, sex, national origin, age, disability, veteran status, pregnancy, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status, status with regards to public assistance or any other protected classification.

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