Insurance verification specialist job description

Insurance Verification Specialist
Pay: $18-21/hr (based on experience)
Job Type: Full-time, Permanent
Hours: M-F 8am-5pm
Location: Onsite - Houston, TX 77030

As an Insurance Verification Specialist, you will play a key role in setting the tone for a positive patient experience by working closely with patients and ordering physicians to ensure services requiring prior authorizations and pre-certifications are obtained when required by medical insurance companies. If you are wanting to make an impact on patients' lives by joining a successful healthcare group, apply today!

A Day In the Life:
Verify insurance eligibility and benefits for specialty services with payers (Commercial and Government) via accessing online payer portals, calling payers, and/or faxing requests. Accurately enter or update patient demographics, insurance coverage, and effective and termination dates in system. Utilize CPT and ICD-10 codes to obtain pre-certifications and prior authorizations for medical services (surgeries, diagnostic testing, etc.) when required by insurance. Calculate patient estimates based on the service schedule, contracted plan reimbursement allowances, benefits, and out of pocket thresholds. Compassionately provide insurance breakdowns to patients in regard to financial obligations, collect patient payments, and provide counselling. Interacts professionally with physicians, patients, patient’s family and co-workers.


Requirements:
One (1) to two (2) years of relevant insurance verification experience preferred Basic understandings of medical insurance benefits Able to read and understand medical documentation effectively Knowledge and understanding of In-network vs Out of Network, PPO, HMO
Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.


#ZR4

Responsible for the intake process for patients referred to Lifetime Pharmacy LLC in regards to all aspects of member's home IV therapy medical insurance benefit, eligibility, patient financial responsibility and policy prior authorization requirements. Assure that all necessary actions are taken to obtain the most complete insurance coverage and provider reimbursement. Performs office functions which will facilitate efficient and accurate processing of referrals for Infusion and Sub Q injection therapy for the delivery of superior patient care. Promotes patient satisfaction with Lifetime Care Home Health and Hospice services and Lifetime Pharmacy, LLC.

STATUS: Part Time (20 hours) LOCATION: RRH Home Infusion PharmacyDEPARTMENT: PharmacySCHEDULE: Day
ATTRIBUTES

• High School diploma, GED or equivalent work experience in a health care environment.• 2-3 years of customer service experience required including home infusion insurance knowledge and experience.• Knowledge of medical terminology.• Ability to interpret electronic data and apply to customer service calls.

RESPONSIBILITIES

• Identifies and determines in accordance with established policies and procedures the accuracy and completeness of home IV insurance and/or demographic information for patient admissions. • Data entry of patient demographic information into computer system.• Provides administrative functions to maintain accurate and organized demographic and intake records for all patients receiving Infusion/Sub Q therapies. • Communicates with Insurance companies to obtain authorization of services to be provided and verifies patient's insurance benefits and assesses patient financial responsibility.• Communicates the necessary Information to the Lifetime Care Home Care Coordinators so patient, Coordinator and Physician can make decisions on how to proceed with the plan of care.

EDUCATION:

LICENSES / CERTIFICATIONS:

PHYSICAL REQUIREMENTS:
S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations.

Rochester Regional Health is an Equal Opportunity/Affirmative Action Employer.Minority/Female/Disability/Veterans by a prospective employee and/or employee's Physician or delegate will be considered for accommodations.

Financial Counselor - Insurance Verification Specialist ($2500 Sign-on bonus)


Copper Springs East is a 72-bed behavioral hospital located in Gilbert, AZ. The hospital offers inpatient and outpatient mental health and addiction treatment to adults, adolescents and their families. At Copper Springs East, we are dedicated to
Changing People's Lives®.


The Financial Counseling Team is devoted to providing exceptional service to our patients and their families. Our team will greet patients and their families with a warm welcoming smile, prior to reviewing financial obligations, and insurance coverage options. Financial Counselors are one of the first steps in creating a strong foundation for long-term healing and recovery. Above all, we truly value that both the patients and our staff are treated with dignity and respect, always going that extra mile to ensure a positive environment. So, do you have what it takes to become part of a team dedicated to
Changing People's Lives®
?


Members of our team Enjoy:


Working with a highly engaged staff Flexible scheduling Career growth Competitive compensation
Daily Pay - We've partnered with DailyPay, a voluntary benefit to offer employees access to their pay on their own schedule


Position Details



Provide guidance to patients in all aspects of their financial responsibilities that result from acceptance of the facility's services. Counselor assesses patients financial ability, determines ability to pay, advises patients on insurance benefits, and explains financial liability. Accurate and timely verification of insurance benefits. Collects payment, negotiates payment arrangement, secures financing, and identifies funding sources. Resolves any confusion the patient may have about their financial obligations to the facility. Accurate and timely verification of insurance benefits.


Qualifications



Requirements:


High school diploma or equivalent, 2 year degree preferred License: Valid driver's license and good driving record. May be required to work flexible hours and overtime.


Preferred Experience:


Previous experience in healthcare collections or a related field, or any combination of education, training, or experience in a healthcare business office preferred.