Insurance Verification Specialist

Are you a value-driven and compassionate individual that believes in providing quality care that has positive effect on our communities? At Community Health Network, we are driven to create extraordinary experiences for our patients and employees. Our objective is to provide opportunities that develop and grow careers in a team-oriented environment focused on patient care.

Job Summary:

The Insurance Verification Specialist (IVS) is responsible for verifying patient insurance coverage, to ensure necessary procedures are covered by an individual’s provider. He/ She is responsible for updating patient benefit information in the organization’s insurance system and verify that existing information is accurate. Also, the IVS should document the amount of payment needed to be collected by front desk staff. Responsible for working with billing team members to direct follow-up resources to specific balance categories for different financial classes.

Duties and Responsibilities:

• Eligibility and Insurance Verifications
• Effectively and accurately verify active health insurance information and interpretation of benefits prior to service being rendered
• Responsible for entering accurate data in E.HR system to ensure that the patients’ insurance information is updated in the organization’s practice management system and verify that existing information is correct
• Prior Authorizations and Referrals
• Effectively and accurately determine if prior authorization is required by insurance plan(s) for any office visit or procedure
• Submit authorization by contacting insurance plan, submitting with proper documentation, prior to service being rendered and maintain active authorization in patient chart
• Ability to thoroughly follow up through finalization process and maintain active authorization in patients’ chart. Must have the ability to focus and work quickly, as insurance paperwork commonly needs to be processed in a timely manner
• File appeals, if necessary, for authorization requests that are initially denied
• Maintain open communication lines with peers in obtaining supporting documents to complete submission of claims in timely manner
• Perform other duties as assigned by the Revenue Cycle Manager

Required Skills/Abilities:

• Familiar with medical, dental, and behavioral terminology
• Familiarity with office equipment: computer keyboarding, calculators, photocopiers, and faxes
• Ability to communicate clearly and effectively
• Ability to work with people of all socioeconomic levels
• Strong team player with a focus on collaboration
• Ability to respond effectively to the most sensitive inquiries or complaints
• Ability to handle multiple projects simultaneously
• Ability to create, and manage data with Microsoft Excel and other Microsoft software programs
• Consumer advocate for quality health care and services

Preferred Skills/Abilities:

• None

Required Education and Experience:

• High school diploma or GED·
• Minimum 2 years in a medical facility

Preferred Education and Experience:

• None

Supervision Responsibilities:

• None

Physical Requirements

• Occasionally required to sit
• Frequently required to talk and stand
• Frequently required to utilize hand and finger dexterity
• The employee must occasionally lift and/or move up to 50 pounds
• Specific frequently vision abilities required by this job include: Close vision, Color vision, Peripheral vision, Depth perception, Ability to adjust focus

Work Environment:

• BLOODBORNE PATHOGENS EXPOSURE LEVEL: 3 (LOW)
• Noise Level:Moderate

\Putting Our Heart into Your Care\
MyCHN (Community Health Network) is a local healthcare provider dedicated to providing excellence in care and service. We currently operate in Brazoria, Harris, and Galveston counties.
MyCHN (Community Health Network) is a healthcare organization with 14 locations throughout the greater Houston area that offers multiple services for whole-person care.

Benefits:

• Health insurance
• Dental insurance
• Vision insurance
• Paid time off
• 401(k)
• 401(k) matching
• Life insurance
• Other
• Flexible schedule
• Disability insurance
• Employee discount
• Mileage reimbursement

Job Type: fulltime

Education: High school degree

Work location: This is a remote position