Insurance Verifier
Summary Works directly with clinics to identify and secure payer referral requirements for maximum reimbursement
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Work requests from a queue or email communication from clinic staff or other source
- Confirm validity of any referrals already on file
- Submit request for needed referrals to appropriate authority or PCP
- Follow up to secure authorization prior to patient appointment to ensure reimbursement
- Provide requested clinical information to PCP to support referral
- Advise clinic staff of any anticipated delays for authorization
- Secure referrals and enter them in the patient’s electronic record
Education and/or Experience
- Strong, working knowledge of insurance payers to include government, commercial and managed care products
- Ability to establish a good rapport with outside providers and third party payers
- Resourceful, steadfast attitude to make sure that patient needs are met timely
- Comfortable with navigating through the payer websites to secure appropriate benefits and authorization requirements
- Excellent verbal and oral communication skills
- Excellent customer service skills are expected with internal and external customers
Other Qualifications:
- Must be able to multitask and demonstrate excellent organizational skills
- Understanding of insurance contracts and networks essential
- Extensive coding and medical terminology preferred
- Computer literate, knowledge of, or ability to learn multiple clinic/hospital software required.