Insurance Verification Professional
1 day ago
We are seeking an Insurance Verification Specialist to join our team.
Job Description:
As an Insurance Verification Specialist, you will play a critical role in supporting healthcare providers, treatment centers, and billing departments by verifying patients' insurance coverage and benefits.
Key Responsibilities:
- Verify Patient Insurance Benefits
- 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.
- Submit 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.
- Track Authorization Expiry and Renewals
- Monitor and track expiration dates for existing authorizations.
- Proactively initiate renewal processes prior to expiration to avoid service disruptions.
- Notify the clinical and administrative teams of any issues or lapses.
- Coordinate with Clinical Staff
- Request and compile necessary clinical documentation for submissions.
- Communicate with clinicians to ensure all required documents are up to date and compliant.
- Ensure Compliance and Accuracy
- Maintain confidentiality and comply with HIPAA and internal data protection policies.
- Ensure accurate data entry, documentation, and reporting of insurance verification and authorization status.
Requirements:
- At least 2 years of proven experience in medical billing, insurance verification, or healthcare administration.
- Strong knowledge of insurance terminology and benefit structures.
- Excellent verbal and written communication skills.
- Detail-oriented with the ability to multitask and manage time effectively.
- Proficient in using spreadsheets, CRM tools, and insurance portals.
- A reliable internet connection and a quiet, professional remote work environment.
The Ideal Candidate:
The ideal candidate will possess excellent analytical and problem-solving skills, with the ability to work independently and as part of a team. They will be proficient in using electronic health records (EHRs), medical terminology, and insurance procedures.
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