Insurance Verification-Medical Office

Job Description

Job Description

POSITION SUMMARY:

**This is not a remote position**

This position will primarily be responsible for verifying insurance benefits for audiology, surgery and diagnostic services recommended by the practice physicians. The position will call insurance companies for benefits, eligibility as well as authorizations. Candidate will also be cross trained into the Front End verification, and the surgery data entry role within the department for coverage purposes. Individual must be organized and be able to manage demanding workload with accuracy. Candidate must be able to work independently, and as part of the team. This position is onsite and not available for remote work.

RESPONSIBILITIES: 

1. Verify policy benefits for all patients with insurance for all locations
2. Work and resolve any outstanding issues with policy benefits verification
3. Pull allergy, audiology, diagnostic, and surgery recommendations from prior day
4. Check schedule dates for all recommendations, enter into queue
5. Pull patients and verify insurance and start or obtain authorizations as needed
6. Review medical polices/restrictions
7. Keep updates on patient authorizations and work appeals as needed
8. Contact patient with any financial responsibility, scan paperwork and finalize notes

KNOWLEDGE, SKILLS, ABILITIES:

1. Ability to be self-motivated and organized to manage own workload with accuracy.

2. Ability to work independently and as a Team Player.

3. Ability to communicate effectively on the telephone with good customer service.

4. Ability to relate to persons with diverse educational, socioeconomic, and ethnic backgrounds.

5. Ability to exercise good judgement to handle calls appropriately.

6. Working knowledge of medical terminology, ICD 10, CPT codes, benefits, and prior authorizations.

7. Ability to work under pressure, meet deadlines and manage several tasks simultaneously. 

8. Ability to maintain professional behavior and promote a positive image of the practice.

9. Must demonstrate consistent professional conduct and meticulous attention to detail.

10. Critical thinking skills and a positive attitude essential.

11. Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements.

12. Ability to handle conflict in a reasonable fashion.

13. Ability to handle confidential and sensitive information.

PHYSICAL ENVIRONMENT/REQUIREMENTS:

• Normal working hours are 8:00 AM to 5:00 PM Monday through Friday; some incidences of work beyond the normal business hours should be expected based on patient demand.
• Professional medical office setting without significant variation in temperature or lightning.
• Performance of basic physical functions of finger dexterity, grasping, clearly understood speaking, hearing, sight (far and near to include data, figures, and computer equipment), and repetitive motion.
• Performance of primarily sedentary work, sitting for extensive periods of time; occasional lifting or moving of object weighing up to 20 pounds.

EDUCATION/EXPERIENCE:

• Graduation from High School or Equivalency.
• Customer service experience preferred.
• Diagnostic/Surgical benefits experience with knowledge of insurance.
• A minimum of 6 months of experience in a medical billing office setting performing all aspects of Insurance Verification to include general benefits information, i.e.., coins/deductible, out of pocket.