Insurance Verification Specialist (Hybrid Schedule)

This position is temporarily a hybrid role due to Covid-19 and is currently requiring working on-site 2 days per week. Please note that this schedule may change at any time due to training and business needs.

A progressive company servicing a prestigious NYC Medical Center is seeking individuals with experience in verification of insurances. Responsibilities include and not limited to Insurance Verification, pre-certification, and authorization and/or referral. This position will be located in our New York City location.

Summary:

The Insurance Verification Specialist I is responsible for verifying health insurance benefits for all new patients or existing patients. This position will contact patient’s insurance company to verify coverage levels and works with patients to walk them through their benefits information. Notify patient and help arrange alternative payment methods when insurance coverage does not cover services.

Essential Functions:

1. Responsible for verifying patient insurance coverage, to ensure necessary procedures are covered by an individual’s provider.

2. Notify patient and help arrange alternative payment methods when insurance coverage does not cover services.

3. Responsible for entering data in an accurate manner in order to update patient benefit information correctly in EMR and verify that existing information is accurate.

4. Perform routine administrative and clerical tasks to keep the offices of physicians and other health practitioners running smoothly.

5. Maintain service standards in accordance with the departmental/organizational policies.

6. Answer patient questions to ensure understanding and patient satisfaction, or refers them to more senior level staff. Maintain confidentiality on matters to which they are privileged.

7. Consistently review eligibility responses in Insurance Verification system.

8. Verify insurance coverage in a timely matter.

9. Request payments from patients and guarantors where appropriate.

10. Perform related duties as assigned within scope of practice.

Minimum Qualifications:

1. High school graduate or GED certificate is required.

2. A minimum of 6 months’ experience in a physician billing or third party payer environment.

3. Candidate must demonstrate working knowledge of contracts, insurance benefits, exclusions and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations.

4. Candidate must demonstrate the ability to understand and navigate the payer adjudication process.

5. Candidate must demonstrate a strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations. Including the ability to diffuse complex situations in a calm and professional manner.

6. Must demonstrate effective communication skills both verbally and written.

7. Ability to multi-task, prioritize, and manage time effectively.

8. Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)

Job Type: Full-time

Pay: $43,000.00 - $48,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Weekly day range:

• Monday to Friday

Education:

• High school or equivalent (Required)

Experience:

• Insurance verification: 1 year (Required)
• Front desk: 1 year (Preferred)

Work Location: In person