Insurance Eligibility Verification Specialist

Insurance Eligibility / Verification Specialist

The Insurance Eligibility/Verification Specialist position will report directly to the Revenue Cycle Manager.

Position Summary

The Insurance Eligibility/Verification Specialist provides various administrative and office support functions for a clinical operation.

Essential Functions & Responsibilities

Obtains needed verifications, referrals, or authorizations for office visits.

Contacts insurance companies to verify coverage and ensure provider participation.

• Researches and resolves eligibility errors.
• Verifies insurance by web or telephone to determine covered/non-covered services.

Patient Assistance

• Calculates patient cost and assists patients with insurance questions.
• Identifies inconsistencies with patient information and insurances to ensure an efficient workflow.
• Discusses benefits and patient responsibility costs for office visit appointment.

Answers telephone and provides information.

Maintains files with referral slips, authorizations, and insurance slips.

Performs other job-related duties as assigned.

• Attends required staff meetings and in-service.
• Adheres to HIPAA guidelines/regulations/annual HIPAA training.

Education

• A high school education or GED.
• Work Experience: 1+ years of relevant experience. Previous insurance verification experience preferred. eCW experience preferred.

Knowledge

• Knowledge of spreadsheet applications.

Skills/Abilities

• Excellent oral and written communication abilities.
• Good interpersonal and public relations skills.
• Solid problem-solving skills.
• Attention to detail.
• Well organized.

Physical Requirements

• The work is sedentary. Typically, the employee may sit comfortably to do the work. However, there may be some walking, standing, bending, carrying of light items, driving an automobile, etc. No special physical demands are required to perform the work.

Interpersonal Skills

• Courtesy, tact, and diplomacy are essential elements of the job. Work involves much personal contact with others inside and/or outside the organization for purposes of giving or obtaining information, building relationships, or soliciting cooperation.

Work Environment

• Environmentally controlled medical office environment. Work hours subject to office needs to ensure coverage during all hours of operation.

Hours Monday - Friday 8am - 5pm