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Medical Billing / Verifications Specialist

Medical Billing / Verifications Specialist

Texas Regional PhysiciansHouston, TX, US
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Job Description

Job Description

Description :

This person is responsible for insurance verification, obtaining prior authorizations, bill insurance claims and follow-up.

  • Obtain authorizations, referrals, GAP exceptions, and Single Case Agreements
  • Manage and prioritize required approvals with consistent follow-up while constantly communicating with the team
  • Provide clinical documentation to insurance companies to ensure timely authorization.
  • Initiate appeals for upfront denied authorizations and follow through until completion
  • Check eligibility and benefits
  • Electronic claims building and submission
  • Chart and coding review
  • Call patients when necessary to verify insurance information
  • Read and analyze EOBs and ERAs
  • Work claims rejects / denials, send corrected claims, submit appeals
  • Stay up to date on CPT, ICD, and LCD guidelines
  • Provide excellent customer service and professionalism to patients

Requirements :

Skills, Minimum Qualifications

  • High school diploma or GED
  • 2 years prior experience insurance verification or medical billing required
  • 2 years prior experience in a medical related field required
  • Ability to multi-task and remain focused while managing a high volume, time-sensitive workload
  • Demonstrate excellent communication and customer service skills
  • Expected to be detailed oriented with above average organizational skills
  • Expected to understand payer medical policies and guidelines and use these guidelines to manage authorizations effectively
  • Familiarity with both governmental and commercials insurance plans
  • Expected to have knowledge of medical terminology related to multispecialty surgical procedures
  • Expected to have excellent computer skills including Excel, Word and Internet use
  • Reliable to work scheduled shifts with limited unplanned absences.
  • Please note that this position is not remote and requires employees to travel to work location.

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