Lead - Insurance Specialist

Job Type
Full-time
Description
Join our amazing team at The Steadman Clinic, and be an integral part of a cutting-edge organization that is amongst the best in the world at what they do. This is an excellent opportunity to take your health care career to the next level in a unique and highly valuable role, or kick it off with a world-class organization in an amazing facility. Vail, Colorado is one of our nation's iconic mountain destinations, and highly desirable spot to live if you love the outdoors. This position is eligible for our excellent benefit packages and perks (including a wellness benefit you can use for your ski pass!), and strong work-life harmony.
The Insurance Lead provides guidance and direction to Centralized insurance staff to ensure smooth functioning of daily operations. The Insurance Lead is also responsible for providing coverage and guidance on all surgical authorizations. This position is responsible for obtaining various types of prior- authorizations, waivers, providing accurate documentation in patients chart, provide estimates and the collection of monies, including private pays, out of network insurance policies in full, deductibles, out of pockets and past due balances from the surgical patient. This job requires excellent communication skills and the ability to comprehend insurance policies for explanation to patients.
Primary Job Responsibilities:

• Provide guidance and direction to Centralized insurance employees, including setting performance standards and delegation of tasks.
• Work with Medical Office Manager (MOM) to establish short- and long-term goals and create action plans and timelines with your team to achieve these goals.
• Onboard new hires and oversee training and competencies in collaboration with Lead Assistant.
• Assist MOM in creating and implementing department policies and procedures.
• As a liaison for the clinical staff, it is essential to work in a collaborative and supportive manner with all clinical team members.
• Handle difficult patient situations and complaints, reporting them to MOM for resolution and recovery.
• Fill in as necessary during times of attrition.
• Periodically reviews departmental processes to ensure efficiency and accuracy.
• Schedule Centralized insurance staff, ensuring all positions are covered when employees are out sick, on vacation or upon termination.
• Discuss all Centralized insurance employee concerns with MOM to help provide solutions and ensure proper communication.
• Oversee & approve time sheets for Centralized insurance employees and handle time off requests.
• Generate and manage correspondences as directed.
• Call insurance company pre-authorization line and provide them with the CPT codes to see if patients plan requires authorization/predetermination and obtain authorization if required.
• If clinical information is required, the ability to provide this information to insurance company and follow up for authorization or denial.
• Oversee the benefit process for all scheduled appointments. If benefits have not been checked within 6 months, responsible for checking benefits and verify patient's eligibility.
• Must document diligently in patients account with regards to all communication with insurance companies, adjustors, and the patient.
• Provide estimates for patients with out of network policies & self pays and collect in full. Provide estimates upon request. If the patient's insurance is out of network must communicate benefits and payment expectations to both the specific doctor's team and patient.
• Obtaining signed waivers prior to patient's surgical date. Follow the protocol of entering information into the financial screen.
• Other duties as assigned.

Requirements

• High school diploma; prefer Bachelor's degree.
• Prior experience in customer service, insurance, and/or medical coding.
• Preferred experience with calling and understanding medical insurance verbiage and policies.
• Ability to fluently speak and understand English.
• Able to work in a fast-paced environment.
• Excellent organization, communication (both written & verbal) and interpersonal skills required.

Benefits:

• Health Insurance (medical, dental, vision)
• Company 401k Contribution
• Paid Time Off
• Paid Holidays
• Basic Life Insurance
• Short and Long Term Disability Insurance
• Referral Program Incentive
• Parking available

We are an Equal Opportunity Employer. We are committed to equal treatment of all employees without regard to race, national origin, religion, gender, age, sexual orientation, veteran status, physical or mental disability or other basis protected by law.
Salary Description
Starts at $25/hour