Insurance Verification & Authorization Specialist

Job Description

Job Description

Description

The Insurance Verification / Authorization Specialist verifies healthcare insurance benefits by utilizing payer portals and making phone calls to insurance companies.

They are responsible for calculating and providing estimated patient responsibility for scheduled services. They are responsible for all aspects of obtaining referrals and authorization for patient care.

This job requires full-time onsite work

Key Responsibilities

• Collaborate with Front Desk, Scheduling, and Clinical Operations teams to complete assigned tasks.
• Monitor voicemail to properly follow-up with patient inquiries in a timely manner.
• Communicate with patients and Aspire staff regarding out-of-pocket cost estimates and financial responsibility as well as authorization requirements.
• Review demographic and insurance information in patient accounts and make necessary corrections.
• Follow policies and procedures to contribute to the efficiency of the business office.
• Completes accurate and timely insurance verification for patient visits / procedures / testing in accordance with company policy, workflow, and department goals.
• Completes accurate and timely third-party payer authorization requests, including ensuring all necessary data elements needed for an authorization (e.

g., CPT codes, diagnosis codes) are available.

• Ensures services scheduled by the scheduling team have approved authorization as required by payer and procedure prior to service.
• Refers underinsured / uninsured patients to the Billing Specialists to see if the patient is eligible for assistance or offer payment options prior to services being received.
• Creates a positive patient experience by being polite, compassionate, and professional.
• Provides cross-coverage and training, when needed, for other team members.
• Maintains productivity and quality performance expectations.
• Regular attendance is required to carry out the essential functions of the position.
• Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge, and abilities to perform, within scope, role specific functions.

Skills, Knowledge & Expertise

• Knowledge of Commercial, Medicare and Medicaid Insurance guidelines.
• Experience working with insurance payer sites such as Medicaid, Medicare, and private insurance carriers.
• Excellent mathematical skills, computer skills, Google suite application skills.
• Excellent verbal and written communication skills.
• Ability to prioritize and manage multiple workflows and responsibilities.
• Strong attention to detail and goal oriented.
• Ability to work in a results-oriented and fast-paced environment, both individually and as part of a team.

Requirements

Required Education and Experience :

• High School Diploma or higher
• Healthcare, hospital, or clinical patient service experience

Preferred education and experience :

• 1+ years of insurance verification and authorization experience in a healthcare setting.
• Bilingual English / Spanish
• CPT / ICD 10 coding knowledge

Benefits and Perks :

• Medical, Dental and Vision Insurance.
• Generous Paid Time Off and 10 Paid Holidays
• Free Allergy Testing and Discounted Treatments
• 401(k) + Generous Employer Match
• Employee rewards program!
• More!

Explore More About Aspire

Instagram - https : / / www.instagram.com / aspireallergy /

LinkedIn - https : / / www.linkedin.com / company / aspire -allergy / mycompany /

TikTok https : / / www.tiktok.com / @aspireallergy

Aspire Allergy & Sinus is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.