Insurance Specialist

Duties and Responsibilities

• Verify insurance eligibility and benefits prior to patient appointments
• Contact patients for correct insurance and coverage information
• Understand when the patient’s coverage plan has in or out of network coverage, requires a prior authorization for services, or a single case agreement
• Submit requests for prior authorizations for mental health services
• Understand, differentiate, and explain to patients their coverage of benefits, deductibles, co-insurance, share of cost and copays
• Contact patients for collections of deductibles, co-insurance, share of cost and copays
• Consistently document communication with insurance companies and patients per the departmental policies and procedures
• Initiate/complete Prior Authorizations with payers as needed
• Work with billing dept in patient collections

Qualifications

• A High School Diploma or equivalent
• Minimum of 1-2 years of experience working with insurance
• Solid understanding of Government, commercial and private payers
• The ability to multitask and manage time effectively
• Excellent verbal and written communication skills
• Outstanding problem-solving and organizational abilities
• A full understanding of HIPAA requirements
• The ability to understand and implement individual responsibilities while prioritizing a team culture
• A basic understanding of Microsoft office suite, with a focus on excel and powerpoint