Insurance Verification Coordinator I

Title: Insurance Verification Coordinator I


Duartion: 3 Months with possible extension/conversion

Work Arrangement: Remote

Responsibilities:

* Obtain and verify insurance eligibility for services provided and document complete information in system

* Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies

* Collect any clinical information such as lab values, diagnosis codes, etc.

* Determine patient's financial responsibilities as stated by insurance

* Configure coordination of benefits information on every referral

* Ensure assignment of benefits are obtained and on file for Medicare claims

* Bill insurance companies for therapies provided

* Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures

* Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs

* Handle inbound calls from patients, physician offices, and/or insurance companies

* Resolve claim rejections for eligibility, coverage, and other issues

Insurance verification for medication; prior authorization appeals; speak to patients, doctors' offices, & insurance plans

Inbound internal que

25 referrals/more a day

95% quality or higher

Attendance is crucial

Candidate Requirements

Education/Certification
Required: High school diploma
Preferred: NA

Licensure
Required: NA
Preferred:

Years of experience required: 1 + years of experience

Disqualifiers: NA

Additional qualities to look for: Proficient in Microsoft Office, experience/backgrounds that do well in this role- Managed Care, Pharmacy, Medical terminology, Physician office experience, Customer Service, Call Center

• Top 3 must-have hard skills stack-ranked by importance

1
Managed Care

2
Customer Service

3
Call Center