Insurance Verification Specialist

Performs insurance verification duties to obtain primary insurance data for use in determining patient’s eligibility for visits, by verifying insurance, correcting patient demographics, obtaining referrals as needed.

• Verify patient benefits and insurance eligibility to update registration and coverage information.
• Responsible for telephone eligibility support. Participate in quality control and solution recommendation to include notification to management team of process issues.
• Handle incoming patients and Clinic questions, in regard to patient copays, deductible and coinsurance coverage and eligibility.
• Responsible for adding and updating all commercial and governmental payers. Obtaining referral/authorization for scheduled patients.
• Review Charge review for registration errors and update for accurate and timely billing.
• Reviews new and follow-up patient registration, obtains and manages referrals, and advises on co-pays and deductibles.
• Contacts PCP and/or Clinic to coordinate and obtain accurate and current referral documentation, once confirming patients have established care.
• Coordinates with UHS referral team and has in-depth knowledge of both registration access tools.
• Effectively navigates between multiple verification tools to obtain thorough eligibility and benefits material.
• Meet current production standards set by the management team to resolve outstanding claims and maintain a healthy accounts receivable.
• Completes all other duties as assigned.

• Some knowledge of patient billing or collection/reimbursement procedures.
• Detail oriented with the ability to organize, prioritize and coordiante work within schedule constraints and handle emergent requirements in a tiemly manner.
• Ability to multi-task in a fast paced, high-volume environment.
• Proficient in Microsoft Office.
• EPIC experience.

EDUCATION:

HS Diploma or equivalent