Medical Insurance Verification

Job Title
Medical Insurance Verification
Job Summary
Verifies eligibility of insurances and submits prior authorizations to insurances prior to
procedures.
General Accountabilities
Understanding of Medicare/Medicaid rules and regulations (Compliance)
Understanding of private insurance rules and regulations (If required in
assignment)
Contact payer/referring physician offices as needed for referrals/authorizations.
Basic understanding of codes and patient medical data
Resolves or clarifies codes or diagnoses with conflicting, missing, or unclear
information by consulting with doctors or others
Identifies discrepancies in documentation.
Audits appeals of denied claims.
Consults classification manuals to locate information about disease processes.
Maintains privacy of medical records.
*The company reserves the right to add or change duties at any time.
Job Qualifications
High School Diploma, GED.
Business functions experience preferred, but not required, preceptorship and
cross training provided
Good communications skills
Computer skills required.
One year experience in medical office
Critical thinking skills
Time management
Skills
Insurance Verification
Insurance Authorization