Insurance Liaison

About the role

Under the direction of the Controller, the Insurance Liaison plays a crucial role in fostering communication and collaboration between the Federally Qualified Health Center (FQHC) and various insurance providers. This position is responsible for managing insurance-related processes, verifying patient coverage, and ensuring accurate billing and reimbursement.

Essential Duties And Responsibilities

• Verify patients' insurance coverage and eligibility
• Collaborate with patients to obtain necessary insurance information
• Update and maintain accurate insurance records
• Work closely with billing and coding staff to ensure accurate claims submission
• Review claims for completeness and accuracy before submission
• Address any insurance-related issues emerging during the billing process
• Establish and maintain strong relationships with insurance company representatives
• Regularly communicate with insurance representatives accordingly
• Stay informed about changes in insurance policies and procedures
• Provide patients with information regarding their insurance coverage and benefits
• Assist patients in understanding and navigating the insurance process
• Address patient inquiries related to insurance matters
• Investigate and resolve insurance-related claim denials and/or rejections by means of the worklog
• Work proactively to prevent claim denials through accurate documentation and communication
• Maintain all passwords for the Managed Care/Third Party carriers who allow verification via provider websites
• Maintain confidentiality of all information/adhere to all HIPAA guidelines/regulations
• Ensure external and internal telephone calls are answered in a professional and timely manner in accordance with department policies, procedures, and performance goals
• Perform other duties that may be assigned by Controller

Requirements/Qualifications

• High school diploma or General Education Degree (GED)
• Preferred minimum of three (3) years' experience in one or more of the following: Medical/Dental Coding Certification and/or knowledge of Current Medical Terminology (CMT), Current Dental Terminology (CDT)
• Relevant work experience in a medical or dental office setting
• Higher level knowledge of Excel
• Ability to effectively communicate both verbally and in writing
• Additionally, establish and maintain effective working relationships with employees, departments, and the public
• Ability to work independently and with a team to obtain objectives
• Proficient in office productivity tools such as Google, email, scanner, etc.