Insurance Verification Specialist
1 day ago
Job Title: Insurance Verification Specialist
About the Role:The Insurance Verification Specialist plays a pivotal role in ensuring seamless patient admissions, billing, and claims processes by verifying insurance coverage and benefits.
This position requires strong communication skills, medical terminology knowledge, and an understanding of insurance procedures to facilitate accurate and timely verification of patient information.
A successful candidate will work remotely to contact insurance companies, gather necessary coverage details, document findings, and communicate with internal teams to ensure efficient service delivery.
Key Responsibilities:- Patient Insurance Verification:
- Contact insurance companies to verify patient coverage and eligibility.
- Gather detailed information on covered services, copays, deductibles, and prior authorization requirements.
- Accurately document all benefit details in the EHR or billing system.
- Authorization Requests:
- Prepare and submit prior authorization requests, including relevant clinical documentation.
- Follow up on pending authorizations with insurance carriers to ensure timely approvals.
- Maintain accurate records of all submitted authorizations.
- Tracking Authorization Expiry and Renewals:
- Monitor and track expiration dates for existing authorizations.
- Proactively initiate renewal processes prior to expiration to avoid service disruptions.
- Notify clinical and administrative teams of any issues or lapses.
- Clinical Staff Coordination:
- Request and compile necessary clinical documentation for submissions.
- Communicate with clinicians to ensure all required documents are up-to-date and compliant.
- Ensure accuracy and maintain confidentiality of patient information.
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