Insurance Verification Specialist

Job Description

Job Description

Description :

Position : Insurance Verification Specialist

FLSA Status : Non-Exempt

Reports To : Director of Operations

PRIMARY FUNCTION / PURPOSE?

The Insurance Verification Specialist plays a vital role in access to healthcare services by ensuring accurate verification and validation of insurance coverage, obtaining pre-authorizations, and entering data accurately into the EHR, thereby facilitating seamless billing and reimbursement processes. The Insurance Verification Specialist must have expertise in medical insurance policies, and excellent communication skills to handle insurance coverage inquiries and interact with patients, insurance providers, and staff. His / her ability to thrive in a fast-paced environment will contribute to the overall efficiency and success of this position.

Requirements :

ESSENTIAL DUTIES AND RESPONSIBILITIES

Insurance Verification

• Verify and validate insurance coverage for patients prior to their appointments or procedures.
• Determine patients' insurance benefits, including deductibles, co-pays, and coverage limitations, to ensure accurate billing and reimbursement.
• Accurately record insurance details and related information into electronic health records (EHR) systems or practice management software.
• Communicate with patients and staff to obtain necessary insurance information, update records, and address any insurance-related concerns or questions, including insurance benefits, financial responsibilities, and out-of-network status.
• Communicate with insurance providers to obtain pre-authorization for medical services, ensuring compliance with their requirements.

Billing

GENERAL PROFESSIONAL DEVELOPMENT

PROFESSIONAL / TECHNICAL KNOWLEDGE, SKILLS & ABILITIES

LICENSES & CERTIFICATIONS

TECHNICAL SKILLS

COMMUNICATIONS SKILLS

IMO is an Equal Opportunity / Affirmative Action Employer.?All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.?