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Insurance Verification Specialist

Insurance Verification Specialist

South Heart ClinicBrownsville, TX, US
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Job Title :

  • Insurance Verification Specialist Department : Billing Position Summary : Responsible for insurance verification, precertification and preauthorizations.

Duties and Responsibilities Include but are not limited to :

  • Assists with the verification of insurance benefits, eligibility, co-pay and deductibles.
  • Precertification / preauthorization of indicated studies.
  • Ensures that all precertifications / preauthorizations are done in advance, before the patient is scheduled for the studies indicated.
  • Submits required notes to the insurance carriers for authorization purposes.
  • Ensures documents (authorization / data / numbers are entered into EHR system appropriately.
  • Communicates with the physicians and nursing supervisor with non supportive documentation.
  • Reviews account information and identify patient balances, flags account for the reception desk and collection department.

    • Communicates with all carriers :

  • Medicare, Medicaid, Commercial, PPO, Network benefits, etc.
  • Seeks advice and guidance from certified coder with regards to coding guidelines and any questions.
  • Greets patients and visitors in a prompt, courteous, and helpful manner.  Checks in patients, verifies and updates necessary information in the patients EMR.
  • Enters all of patient information into the medical billing system.
  • Maintains appointment schedule and follows office scheduling policies.
  • Communicates with patient and providers.
  • Scheduling, canceling, and rescheduling patient appointments.
  • Reminding patients of upcoming appointments and tracking missed appointments.  Answering multiple telephones and accurately documenting messages.
  • Forwarding telephone calls appropriately and following up on return calls.
  • Checking-in patients and properly documenting registration.
  • Collecting co-pays and cash from patients, getting authorization on credit cards.
  • Maintains work area and lobby in neat and orderly manner.  Practice and adhere to HIPPA regulations.

    • Qualifications and Specifications :

  • Education-High School Diploma some college preferred.
  • Knowledge of basic office procedures.
  • Knowledge of basic office equipment including copier, fax machine, and computer.
  • Ability to speak clearly concisely.
  • Skills in dealing with interpersonal issues and patient relations.
  • Ability to handle multiple priorities at once with minimal supervision.
  • Knowledge of medical terminology.
  • Ability to maintain confidentiality of patient information.

    • All employees are expected to :

  • Understand the mission and vision of the clinic.
  • Operate within the concept of patient focused care.
  • Evolve into an effective team member.
  • Maintain good grooming and personal hygiene habits.
  • Adhere to attendance policies.
  • Conform to employee policies and office procedures.
  • This description is intended to provide only basic guidelines for meeting job requirements, responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.
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    Insurance Verification Specialist • Brownsville, TX, US