Role Description
The Insurance Verification Specialist I specializes in verifying patient insurance coverage, ensuring that correct insurance information is secured in the practice management system. This position requires professionals to spend extensive time researching accounts to determine correct insurance coverage and heavy interaction with insurance companies and patients.
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Resolve accounts with unverified insurance coverage.
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Research system notes to discover proper insurance coverage.
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Contact patients as appropriate to obtain proper insurance coverage.
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Contact insurance company(s) as appropriate.
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Verify insurance via system tools, payer portals (Electronic Query [Real-Time-Eligibility]/Insurance Payer Portal/Phone), and obtain benefit coverage.
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Confirm effective and termination dates of patient insurance and update patient's insurance coverage and changes in the billing system.
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Resolve any issues with coverage and escalate any complications to supervisor/manager.
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Correct identification and selection of appropriate registered insurance.
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Correct errors in various work queues to ensure correct claim filing or refiling of denied claims.
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Notify the servicing providerβs office personnel in a timely manner if registration is lacking critical information needed to bill for services.
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Perform other job duties as required.
Qualifications
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High school graduate or GED certificate is required.
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A minimum of 6 monthsβ experience in a physician billing or third party payor environment.
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Ability to understand and navigate the insurance verification process, including coordination of benefits.
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In-depth understanding of In/Out of Network Benefits and how they relate to co-insurance and deductibles due.
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Strong customer service and patient-focused orientation.
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Ability to communicate, adapt, and respond to complex situations, including diffusing complex situations in a calm and professional manner.
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Effective communication skills both verbally and written.
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Ability to multi-task, prioritize, and manage time effectively.
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Functional proficiency in computer software skills (e.g., Microsoft Word, Excel, Outlook, E-mail, etc.).
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Experience in Epic and/or other electronic billing systems is preferred.
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Proficiency in health insurance benefits, eligibility requirements, and obtaining authorizations is preferred.
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Knowledge of insurance billing requirements is preferred.
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Knowledge of medical terminology, diagnosis, and procedure coding is preferred.
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Previous experience in an academic healthcare setting is preferred.
Requirements
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Must reside in the Tri-State area.
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Occasional requirements to visit the office for training, meetings, and other business needs.
Benefits
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Competitive comprehensive benefit package to eligible employees.
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Healthcare and various other benefits including Paid Time Off to promote a healthy lifestyle.
Company Description
At 61st Street Service Corporation, we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. We are an equal employment opportunity employer and adhere to all requirements of all applicable federal, state, and local civil rights laws.