INSURANCE VERIFICATION SPECIALIST

About the role

The Insurance Verification Specialist at Medix Infusion is responsible for verifying insurance eligibility and benefits for infusion services. This role involves reviewing payer medical necessity guidelines and ensuring proper documentation is on file to support therapy. The Insurance Specialist works closely with the Intake, Scheduling, Pharmacy, and Clinical departments to manage patient care.

Responsibilities

• Verifies insurance eligibility and benefits via phone, fax, or payer portals.
• Provides timely completion of insurance review for established patients.
• Documents timely and accurately in the EMR system.
• Reviews payor medical policies to determine medical necessity and/or FDA guidelines including Medicare billing and coding guidelines.
• Collaborates with medical providers to obtain necessary documentation to support medical necessity.
• SUBMIT APPEAL REQUESTS TO PAYERS FOR DENIED AUTHORIZATIONS AND FOLLOW-UP ON TIMELY TURNAROUND.
• OBTAINS AUTHORIZATION FOR INFUSION SERVICES FOR ESTABLISHED PATIENTS.
• KNOWLEDGE OF REIMBURSEMENT POLICIES.
• Completes follow-up tasks as assigned.
• ASSURES WORK IS COMPLETED IN A TIMELY MANNER TO PREVENT DELAYS IN PATIENT CARE.
• ATTENDS DEPARTMENTAL MEETINGS AND INSERVES AS REQUESTED.
• AIDES WITH ORIENTATION AND TRAINING OF STAFF.
• DEMONSTRATES COURTEOUS, COMPASSIONATE, AND PROFESSIONAL BEHAVIOR AT ALL TIMES.

Qualifications

• Two years of insurance verification and authorization experience.
• Two years’ experience in an infusion specialty preferred.
• Experience working with all payer types, including Medicare, Medicaid, and commercial insurance companies.

Benefits

• Excellent Culture as ranked by our own employees (NPS Score)
• We Put the Patient First – Treating Others the Way We Want Ourselves or Our Family Treated
• We Do the Right Thing…Team Matters – We Always Assume Positive Intent
• Health Insurance (Company pays approx. 70% of medical coverage chosen)
• Dental/Vision Insurance (voluntary)
• Paid Time Off – tiered plan based on tenure starting at 120 hours annually
• Paid holidays – 7 days per year
• $50,000 life insurance/$50,000 AD&D Employer Paid (additional Voluntary Life/AD&D products available)
• Disability income protection plan (optional)
• 401(k) savings plan and company match

Pay

$50,000 annually

Schedule

Full-time

Contact Information

To apply for this position, please click the APPLY button above. For more information about Medix Infusion, visit our website.