Insurance Verification Specialist / Specialty Billing Representative

Job Description

Specialty Billing is responsible for verifying all benefits as they pertain to specialty drug injections and all the co-pay assistance funds. They are also responsible for following up with accounts receivable for any necessary payer.

Essential Functions

• Verifies all benefits for scheduled injection appointments.
• Evaluates all benefits for patient responsibility and notates accurate collection amounts.
• Obtains all necessary pre-authorizations or pre-determinations for each patient to have treatment with a specialty drug.
• Maintains up to date billing knowledge of insurance carriers and their clinical policies.
• Works overtime as needed.
• Travels to other MAR locations as needed.
• Performs other duties as assigned.

Competencies

• Problem Solving / Analysis - Creative problem solving within defined acceptable parameters.
• Customer Service - Superior listening skills, professional demeanor, and appropriate firmness.
• Conflict Resolution - Responds promptly to customer needs.
• Detail Oriented - Ensures proper procedures, protocols and processes are complied with consistently.
• Strong Interpersonal Skills - Works effectively with patients, employees, and physicians.
• Time Management - Maintains high volume productivity level for essential functions.
• Ethical Conduct - Maintains confidentiality.

Required Education And Experience

• Medical billing experience preferred.
• Knowledge of benefit investigation including obtaining eligibility information, authorizations, and referrals.
• Experience with CPT codes and ICD-10.
• Microsoft Office Suite required.