Insurance underwriter Jobs in Rochester, NY

Job Description

Job Description

JOB SUMMARY :

The Insurance and Verification Specialist processes patient information for billing purposes. Will verify patient insurance information and authorizations.

DUTIES AND RESPONSIBILITIES :

• Confirms primary and secondary payers, verifies insurance identification numbers and prior approval numbers, obtains correct insurance coverage, and notifies Medical Receptionists of patient insurance co-payment due by contacting insurance companies, doctors’ offices and patients via telephone. Verifies insurance coverage for local HMOs electronically.
• Oversees the review of scheduled patient appointments for self-pay patient accounts to ensure arrangements for pre-payment, and assists in the daily review of preliminary insurance information to determine ASC coverage.
• Submits claims to various payers daily.
• Reviews, researches and resubmits with required documentation denied and problem claims daily.
• Prepares, reviews, and mails self-pay statements monthly or as needed.
• Monitors complete self-pay receivables and write-offs delinquent receivables and sends data to external collection agency.
• Responds to patients’ billing questions by telephone and / or in person.
• Transmits billing information to third party payers electronically and follow-up to ensure information was received; resubmits information, if necessary.
• Reviews the accounts receivable aging and evaluates claims 60 days and older for collection procedures and makes appropriate telephone calls to insurance companies / responsible parties for collection or resolution.
• Performs such similar, comparable, or related duties as may be required.
• Ensures a pattern of reliability in performing the “Essential Duties” of this position through the maintenance of a satisfactory attendance record.
• Other duties, as assigned

EDUCATION :

High School graduate or equivalent. Healthcare experience preferred.

PERSONAL QUALIFICATIONS :

Excellent physical and mental health.

Personality traits capable of enhancing team spirit.

Demonstrates leadership ability.

Demonstrates ability to communicate effectively.

Strong attention to detail.