RCM/OPH Insurance Verification Specialist
EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to patients with a mission to enhance vision, advance eye care, and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, spanning the eye care continuum.
About the Role
As a member of the Revenue Cycle Management Team, the Insurance Verification Specialist is responsible for all aspects of insurance verification. This position will complete pre-registration processes and communicate pertinent appointment information to Front Desk, Patient Intake Specialists, the Prior Authorization Department, or the Clinic, as needed.
Responsibilities
- Obtain information about patient insurance coverage, benefits, and eligibility
- Maintain strict confidentiality in accordance with HIPAA regulations and Company/Clinic requirements
- Provide support to all departments and patients regarding insurance questions related to eligibility and benefits
- Answer incoming and transferred calls from patients regarding the pre-registration process
- Prepare patient appointments for a smooth and efficient check-in process on the day of the appointment
- Adhere to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service
- Perform other duties that may be necessary or in the best interest of the organization
Requirements
- High School Diploma or GED
- At least one (1) year of medical office experience required; medical office/front desk experience preferred
- Comprehensive understanding of insurance verification
- Ability to enter data into various electronic systems while maintaining the integrity and accuracy of the data
- Ability to perform essential job functions with a high degree of independence, flexibility, and creative problem-solving techniques
- Ability to function effectively under stress of conflicting demands on time and attention while successfully meeting deadlines
- Ability to maintain control of a call, de-escalating issues, and instilling confidence that a resolution will be found
- Logical and critical thinking skills
- Excellent organization, time management, and prioritization skills
- Professional in appearance and actions
- Enjoys learning new technologies and systems
- Detail-oriented, professional attitude, reliable
- Exhibits a positive attitude and is flexible in accepting work assignments and priorities
- Meets attendance and tardiness expectations
- Management and organizational skills to support the leadership of this function
- Interpersonal skills to support customer service, functional, and teammate support needs
- Able to communicate effectively in English, both verbally and in writing, with sufficient grammar and spelling skills to avoid mistakes or misinterpretations
- Basic to intermediate computer operation proficiency with Microsoft Excel, Word, and Outlook
- Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines
Location/Work Environment
- For on-site team members, work takes place in a normal office/clinical environment. Travel to other locations may be necessary to fulfill essential duties and responsibilities. Those needing to travel for work must have access to dependable transportation, and their driving record must meet company liability carrier standards.
- For remote team members, a HIPAA-compliant home office environment is required. Ability to work in a remote environment while performing required duties and remaining patient-focused.
- Able to work varying shifts including early mornings/evenings to attend meetings and cross-training or support other initiatives.
Must reside in one of the following states: AL, AZ, FL, GA, IL, IN, KS, KY, MI, MN, MO, NC, NJ, OH, OK, PA, TX, VA.