Insurance Verification Specialist

2 days ago


Iloilo City, Western Visayas, Philippines TMDPH INC Full time
Job Title: Insurance Verification Specialist

We are seeking a detail-oriented and organized Insurance Verification Specialist to join our team at TMDPH Inc. The Insurance Verification Specialist plays a critical role in verifying patients' insurance coverage, ensuring accurate billing, and facilitating smooth administrative processes.

Key Responsibilities:
  • Verify patients' insurance coverage and benefits by contacting insurance providers, utilizing online portals, and reviewing insurance documentation.
  • Accurately record insurance information, policy details, and coverage limitations in electronic health record (EHR) systems.
  • Confirm patients' eligibility for medical services, procedures, and treatments based on insurance guidelines.
  • Collaborate with healthcare providers, billing teams, and administrative staff to ensure accurate billing and reimbursement.
  • Educate patients on their insurance coverage, co-pays, deductibles, and any pre-authorization requirements.
  • Obtain necessary pre-authorizations for medical procedures and treatments as required by insurance plans.
  • Assist in resolving insurance-related inquiries and discrepancies, coordinating with insurance companies to address issues.
  • Maintain patient confidentiality and adhere to ethical standards when handling sensitive insurance information.
  • Contribute to streamlining insurance verification processes and improving efficiency.
  • Ensure compliance with privacy laws, and data security guidelines, including Health Insurance Portability and Accountability Act (HIPAA) standards.
Qualifications:
  • Bachelor's Degree in any field. Some college education in healthcare administration or related fields is preferred.
  • Familiarity with using insurance verification software, electronic health record (EHR) systems, and office applications.
  • Strong understanding of medical billing procedures, insurance plans, and coverage guidelines.
  • Excellent written and verbal communication skills for effective interactions with patients, insurance representatives, and medical professionals.
  • Exceptional attention to detail and accuracy in recording insurance information.
  • Experience:
    • Minimum of 1 year(s) experience in medical office administration, insurance verification, or a related role.
    • Undergraduate applicants with a minimum of 1 year experience is also considered for this position
    • Familiarity with various insurance plans, including Medicare, Medicaid, and private insurers.
Personal Attributes:
  • Professional and courteous demeanor when interacting with patients and insurance representatives.
  • Strong organizational skills to manage insurance verification processes efficiently.
  • Ability to work independently and collaborate within a healthcare team.
  • Adaptability to evolving insurance regulations and healthcare technologies.


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