Insurance Verification Specialist (72422)

About the role

The Insurance Verification Specialist at Women’s Care is responsible for performing all activities related to third party payer pre-certification functions for Women’s Care services. This includes contacting insurance companies via telephone and/or insurance websites for eligibility, eligibility dates, deductible, co-payments, and co-insurance amounts due. The role also involves verifying eligibility and benefits prior to patient’s scheduled appointments or procedures, documenting all necessary information in appropriate systems, determining provider participation status with payer, answering incoming billing customer service phone calls and emails, and demonstrating and embodying the Women’s Care mission and core values.

Responsibilities

• Contact insurance companies via telephone and/or insurance websites for eligibility, eligibility dates, deductible, co-payments, and co-insurance amounts due.
• Verify eligibility and benefits prior to patient’s scheduled appointments or procedures.
• Document all necessary information in appropriate systems.
• Determine provider participation status with payer.
• Answer incoming billing customer service phone calls and emails.
• Demonstrate and embody the Women’s Care mission and core values.
• Comply with all HIPAA rules, regulations, and guidelines.
• Perform other duties as assigned.

Qualifications

• A high school diploma or equivalent required.
• A minimum of 1-2 years’ medical billing/insurance verification experience.
• Solid working knowledge of HMO’s, PPO’s, Medicare, Medicaid, PAC, Commercial, Worker’s Comp, and liability insurances.
• Ability to interact with patients, families, staff, management, physicians, insurance representatives, and other third-party payers.
• Knowledge of CPT, ICD-10, and medical terminology.
• Excellent customer service skills, both verbal and written.
• Proficiency in all Microsoft Office programs.
• Must be highly detail-oriented and organized.
• Able to handle stressful situations tactfully.
• Demonstrate excellent problem-solving skills.
• Able to work in a fast-paced, ever-changing environment.
• Dependable, reliable, and punctual.