Insurance Verification Specialist

About the role

RCM INSURANCE VERIFICATION SPECIALIST performs clerical functions for patient billing, including verification of insurance information and resolution of problems to ensure a clean billing process. Follows up on accounts that require further evaluation. Works with others in a team environment.

Responsibilities

• Maintains patient demographic information and verifies, enters or updates insurance information for new patients and existing patients to include copays and deductibles
• Verifies insurance eligibility for upcoming appointments by utilizing EMR, online websites or by contacting the carriers directly
• Explain financial responsibilities to patients
• Coordinate with staff and management regarding scheduling errors. Update the error spreadsheet daily
• Update the error spreadsheet daily
• Enter insurance effective dates and/or authorization details
• Participates in development of organization procedures and update of forms and manuals
• Answers questions from patients, clerical staff and insurance companies
• Works in conjunction with the reception to ensure clean billing
• Performs miscellaneous job-related duties as assigned
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations
• Assists in development and communication of SOP for key areas to improve accuracy and understanding of processes
• Process Check assigned locations daily and confirm eligibility, copay, and outstanding balance for every scheduled patient
• Enter and update carrier details in the insurance section of the patient account to include plan name, effective dates, co-pays and deductibles
• Flag and address potential errors
• All errors should be logged onto the Eligibility Error Spreadsheet
• Add copay and outstanding collection notes in the appointment details for the PSR to see and address during the check in process
• If further action is needed, due to portal downtime or insurance errors, enter notes into the appointment details for the PSR to see
• Maintain regular verification management at least two days ahead of schedule
• Attempt to collect outstanding balances and/or work with RCM management to assist with questions

Qualifications

• Minimum of 1 year working in a medical office
• Medical Billing experience preferred
• Must be comfortable asking for payment
• Must have outstanding phone etiquette and attention to detail

Benefits

• Medical, Dental, Vision Coverage
• Life Insurance
• Paid Time Off
• Long Term Disability
• 401K Plan

Job Type

Full-time