Insurance Specialist

About the role

The Insurance Specialist will evaluate a patient’s insurance status and assist with ensuring eligibility of coverage for timely and efficient billing. The work includes accessing our partner hospital’s electronic health record to verify insurance eligibility. Continuously monitor accounts to place appropriate insurance, or eligible charity care programs to ensure timely filing. The Insurance Specialist validates all pertinent demographic and insurance information is available and accurately documented.

Responsibilities

• Access partner hospital’s electronic health record system for monitoring updates regarding insurance coverage.
• Verify and assure all accounts are ready for billing with adequate supporting documentation, within the established time frames.
• Supports patients and their family members to assure patients have access to all available funding.
• Aid in customer service resolution with concerns regarding financial services.
• Create patient responsibility estimates based on the insurer’s coverage and benefit information, as well as collect applicable patient responsibility portion.
• Communicate on behalf of financial services with other specialty clinic locations and physician offices.
• Handle inbound and outbound calls including but not limited to customer service calls, account inquiries and coverage benefits and eligibility status.

Requirements

• Associate Degree or Minimum 3 years of hospital experience and working knowledge of patient accounting functions including pre-admissions and admission registration will be considered in lieu of an Associate Degree.
• Minimum 1 year Family Financial Advocate experience, in addition to Registration, insurance, billing, and/or relevant experience required for FA I.

Qualifications

• Excellent communication skills.
• High-level customer service.
• Healthcare finance knowledge.

Skills

• Knowledge of electronic health record systems.
• Ability to communicate effectively with patients, guarantors, and other stakeholders.
• Strong attention to detail.
• Ability to manage multiple tasks and prioritize responsibilities.

Benefits

Nemours offers competitive compensation and comprehensive benefits, including medical, dental, vision, retirement plans, and paid time off.

Pay

Compensation is commensurate with experience.

Schedule

The schedule is flexible and can vary based on department needs.

Benefits

Nemours offers competitive compensation and comprehensive benefits, including medical, dental, vision, retirement plans, and paid time off.