Insurance Benefits Verification Specialist, RCM

Job Description

Job Description

This Specialist will join the insurance verification team and be responsible for patient registration and eligibility verification, benefits investigation, cost estimation, and other tasks related to patient account balances. The Revenue Cycle Management (RCM) team is seeking an individual with experience in insurance eligibility and/or claims processing, as well as critical thinking skills, attention to detail, and the ability to learn quickly and adapt to a dynamic environment.

Education/Experience:

• High School Diploma required
• Two years of experience in healthcare administration/revenue cycle
• CRCR Certification preferred

Skills:

• Demonstrates excellent customer service
• Ability to convey empathy
• Strong problem-solving, problem-prevention, and decision-making skills
• Ability to manage and prioritize multiple tasks in a fast-paced environment
• Excellent oral and written communication skills
• Ability to maintain composure and restore calm in a stressful situation
• Uses good judgment and diplomacy when dealing with others
• Desire and ability to work in a team environment
• Computer proficient with the ability to learn multiple software applications
• Ability to work with minimal supervision

Primary Responsibilities:  The purpose of this position is to execute actions on patient account details, including insurance eligibility and benefits verification, cost estimation, answering patient calls, and performing patient account follow-up tasks in the assigned area of the Revenue Cycle process.

Essential Functions:

• Help develop &maintain a corporate culture that supports the mission and values of Mayfield Clinic
• Verify patient eligibility and benefits in an accurate, timely manner; prepare cost estimates and pre-collect on scheduled services, register new patients, prepare payment plans, and perform other tasks as required.
• Make all necessary corrections to patient accounts in collaboration with the claims follow-up team.
• Research unpaid patient balances and communicate with patients and 7 clinical office staff as needed to pursue payment. Ensure that questions and requests for information are addressed in a timely & professional manner to ensure resolution & reimbursement.
• Ensure timely & accurate posting of patient payment information, and follow up with patients as needed to ensure full, expected reimbursement for services provided.
• Maintain documentation and update our practice management system for appropriate claims submission & other pertinent information to identify action taken.
• Make necessary adjustments as appropriately required by plan reimbursement & company policy.
• Prioritize accounts based on aging and outstanding dollar amounts or as directed by management.
• Research & initiate requests for refunds for accounts with credit balances.
• Answer & initiate phone inquiries regarding bills, charges, claims, and account status.
• Update data in the practice management system as required.
• Contribute to the team environment by performing other duties as assigned.

Physical Requirements:

• Hand Movement, including repetitive motions, grasping, holding, and finger dexterity. Reading, Writing, and Hand-Eye Coordination. Vision, including color distinction, and visual inspection. Hearing, Talking, Sitting, Lifting up to 10 pounds, Bending, Reaching

Mayfield Clinic Mission:  To provide the best neurological care for our patients through:

• Superior clinical outcomes
• Compassionate patient care
• Education and research
• Innovation

Mayfield Clinic Values:  All associates who are affiliated with the Mayfield Clinic must agree to use these values as a basis for their employment, and recognize that they are part of the associate’s annual Performance Review and Development Plan:

• Integrity: We commit to honest and ethical behavior in all of our endeavors and interactions.
• Excellence: We commit to the highest level of performance and continuous improvement.
• Respect: We embrace the importance of all individuals & value their diverse backgrounds, skills & contributions.
• Compassion: We commit to being compassionate and empathetic in all of our interactions.
• Collaboration: We embrace teamwork, mentoring, cooperation, sharing of expertise, & empowerment.