Insurance Verification Specialist

Robert Half is hiring a full-time Insurance Verification Specialist to join our client! This candidate will work closely with the Revenue Cycle Manager while performing all components in the Insurance Verification/Authorization process for existing and new patients, as well as working closely with staff. This person will act as the connection between internal and external customers to assist in the account billing resolution process and escalate issues which impact claim submission and payment. The ideal candidate will encompass excellent customer service and keen attention to detail.
If you are interested in this opportunity, contact Paige @563-214-1543!

REQUIRED QUALIFICATIONS:

Experience with Microsoft Word, Excel and Outlook
Learn new programs and systems
Read and evaluate Healthcare Receivables Information
Effectively communicate to the staff, management and payers
Experience with all payer types such as commercial, governmental, Medicare, Medicaid, and HMO

PREFERRED QUALIFICATIONS:

High school diploma or equivalent
1 or more year(s) in Healthcare Customer Service, Insurance Verification and Billing System
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Conduct Insurance Verification and authorization validation on scheduled patients to ensure eligibility and benefits for accurate claim submission and payment.
Utilize SSI online eligibility verification system
Request pre-authorization for scheduled procedures, urgent procedures and imaging.
Accurately notate the account with actions taken for pre-certification.
Coordinate Peer-to-Peer reviews with providers for denied requests.
Follow up on pending authorization requests in a timely manner.
Communicate with Patient Financial Advocate regarding patient’s financial responsibility
Review confirmation reports to identify payer rejection issues and execute payer procedures needed to reduce occurrence of future rejections.
Perform independent research
Identify billing or payer edit opportunities
Assist management team in providing training and assistance to other staff members with issues of billing, collection and/or denial processing techniques.
Communicate areas of concern regarding account billing or collections to a manager in a timely manner
Follow department policies and procedures as required to meet payer and regulatory requirements