Verification Specialist

• Verify patient health care insurance benefits
• Calling insurance companies and obtain patient benefit information
• Confirm insurance plan and policy effective/term dates
• Confirm insurance benefits and provider reimbursement
• Calling patients to confirm insurance and demographic information
• Confirm prior-authorization requirements by calling insurances or utilizing insurance provider portals
• Reviewing medical records and verifying medical necessity
• Processing and inputting Durable Medical Equipment Orders
• Manage multiple tasks, projects and deadlines at the same time
• Assist multiple teams and work assigned projects
• Following up with insurance companies on billing and reimbursement discrepancies
• Submitting adjustment and refund requests
• Reviewing insurance EOB/Remittance Advice and Posting Payments and Adjustments
• Reconciling and Auditing Posted Payment Lines
• Reviewing AR Aging Reports and submitting accounts to third party collections
• Meet or exceed required level of Key Performance Indicators (KPIs) in all measured areas

Education:

• High school graduate or equivalent.

Experience Required:

• Healthcare or durable medical experience
• Some familiarity with Insurance Billing and Reimbursement guidelines
• Reviewing and understanding Medical Records
• Reviewing and understanding Insurance EOB/Remittance Advice
• Some familiarity with Medical CPT/HCPC’s
• Some familiarity with Medical Diagnosis ICD 10 Codes

Skills:

• Works efficiently with minimal supervision while exercising sound judgment.
• Any remote/remote position requires minimal distractions and work area must meet HIPAA requirements.
• Ability to multitask, learn and manage complex tasks.
• Excellent public relations skills and demonstrated ability to communicate and maintain effective relationships.
• Be professional and articulate in both verbal and written communication
• Be well-organized, self-motivated, and have the ability to prioritize tasks and meet deadlines.
• Ability to work in a fast-paced environment independently or as part of a team.
• Have strong computer skills with proficiency in Microsoft Word, Outlook, Excel, and efficient typing skills of 40 wpm.
• Ability to withstand varying job pressures, organize/prioritize related job tasks, and excellent attention to detail.
• Ability to problem solve and promote positive resolutions and outcomes.
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
• Demonstrated effective interpersonal skills which promote cooperation and teamwork.

Benefits:

• 401k plan
• 401k Matching
• Medical
• Dental
• Vision
• Life Insurance
• PTO (paid time off)
• Fun & Wellness Day with $50 reimbursement
• Flexible Schedule
• Work from Home