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Top 50 Insurance Verification Specialist Skills

Below we've compiled a list of the most important skills for an Insurance Verification Specialist. We ranked the top skills based on the percentage of Insurance Verification Specialist resumes they appeared on. For example, 41.1% of Insurance Verification Specialist resumes contained Insurance Companies as a skill. Let's find out what skills an Insurance Verification Specialist actually needs in order to be successful in the workplace.

These are the most important skills for an Insurance Verification Specialist:

1. Insurance Companies

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high Demand
Here's how Insurance Companies is used in Insurance Verification Specialist jobs:
  • Verify patients' medical insurance for upcoming medical appointments by using internet websites or contacting insurance companies by phone.
  • Initiated contact with insurance companies for verification of benefits and authorization of inpatient and outpatient services.
  • Verified patient insurance contacting insurance companies prior to treatment and physicians visits.
  • Called insurance companies for explanation of payments to ensure accurate compensation.
  • Facilitate pharmacy and major medical claims with insurance companies and practitioner.
  • Called insurance companies to verify benefits and eligibility.
  • Communicate with insurance companies regarding Patient benefits.
  • Called insurance companies to verify coverage and obtain benefit information such as deductible, coinsurance, and max out of pocket.
  • Called various insurance companies to verify eligibility and coverage, also what type of insurance, vision, dental and medical.
  • Call insurance companies to check eligibility and find out if an authorization is required for radiation treatment therapy for the patient.
  • Corresponded closely with PCP offices, insurance companies, and the office billing department on a daily basis.
  • Updated and kept track of the providers' participation with over 40 insurance companies via internet or phone.
  • Handle inbound calls from patients, physician offices, insurance companies, and internal departments.
  • Spend extensive amount of time on the phone with the insurance companies.
  • Called insurance companies and verified a patient s coverage for upcoming procedures.
  • Called insurance companies to get eligibility and benefits for each patient.
  • Work claim denials and bill claims to insurance companies for payment.
  • Submitted payment requests to Dental Insurance companies.
  • Produced claims for insurance companies.
  • Call insurance companies and verify medical insurance * Create initial electronic patient file typing an average of 50 WPM

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10 Insurance Companies Jobs

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2. Medical Procedures

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high Demand
Here's how Medical Procedures is used in Insurance Verification Specialist jobs:
  • Obtained authorizations for medical procedures, updated medical profiles.
  • Served as a valued member of the health care team, helping patients get the medical procedures they need.
  • Called insurance companies regularly to obtain prior authorization for DME, medical procedures, and surgeries.
  • Obtain the necessary authorizations and compliance for the patients' medical procedures.
  • Received orders from doctor's offices for medical procedures.
  • Obtain authorizations for medical procedures and or medical care.
  • Obtain Prior Authorizations for Medical Procedures and Surgeries.
  • Worked directly with utilization nurses to pre-certify medical procedures to be covered prior medical procedures.
  • Ensured receipt of health insurance preauthorization for medical procedures.
  • Pulled charts in medical records to obtain precertification for specific medical procedures by identifying CPT and ICD-9 codes.
  • Assisted the doctor with medical procedures such as Botox, Fillers and Spinal Injections.
  • Verified patient benefits and eligibility Obtained authorization of surgical & medical procedures Acquired insurance referrals

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3. Medicaid

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high Demand
Here's how Medicaid is used in Insurance Verification Specialist jobs:
  • Verified eligibility and benefits for patients with Commercial insurances and Medicaid for Durable Medical supplies.
  • Directed credentialing process for physicians with Medicare and Medicaid in New Jersey and Pennsylvania.
  • Verified medicaid benefits daily for patients according to department goals.
  • Verified Medicare and Medicaid eligibility for patients who qualify.
  • Research other open polices dealing with Medicaid and Medicare but, not limited to spouse and /or children.
  • Be a source of knowledge and expertise with regard to Medicare, Medicaid, and Private Insurances.
  • Called private insurance companies, Medicare, and Medicaid to obtain benefit information.
  • Prepare, process and analysis month end reporting for Medicaid recipients.
  • Experienced in verifying Medicare, Medicaid and private insurances.
  • Experienced with working with UH, Medicaid/Medicare patients.
  • Worked with Medicaid insurances and entities.
  • Maintain Knowledge of state Medicaid systems.
  • Verified Medicaid, Medicare and insurance benefits, insurance coverage, prior authorizations, collect deductibles and copays
  • Pre-registered patients for inpatient acute rehab services and verified Medicare and Medicaid eligibility for patients.
  • Work on doctor schedules a week in advance and verify patient eligibility through Availity, the Medicaid portal, and gateway.
  • Send Medicaid case's off for a review to see if Medicaid will cover the full case or not.
  • Worked ques that included medicaid, dental, vision, and behavorial health policies.
  • Obtained Pre-certifications and Referrals for Medicare and Medicaid Recipients.
  • contacted patients and medicaid payors to obtain additional information.
  • Experience with Medicaid and Medicare eligibility Trained and confident in using Navinet and Avality

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2 Medicaid Jobs

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4. Customer Service

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high Demand
Here's how Customer Service is used in Insurance Verification Specialist jobs:
  • Provided the highest quality customer service internally and externally to customers by maintaining proper standards for provider and customer interactions.
  • Maintained positive customer service at all times, referring unresolved issues to appropriate supervisor.
  • Preformed daily customer service skills, telephone etiquette, and alpha/numerical data entry.
  • Delivered exceptional customer service in a high call volume sales environment.
  • Provided telephone and public customer service.
  • Utilize interpersonal skills and extensive on-the-job training to provide professional, knowledgeable, helpful, courteous, and responsive customer service.
  • Completed required customer service certification classes, also cross-trained for various Medical Insurance lines of business, and products.
  • Provided customer service support for 9 satellite locations for the high call volume from the automatic call distribution system.
  • Used exceptional customer service skills to ensure full client satisfaction and to help build the reputation of the company.
  • Executed customer service by contacting current customers to see if they needed a refill on their medical supplies.
  • Provide the very best customer service to internal/external customers (approximately 50-100 calls per day).
  • Submitted patient polices by having excellent customer service and time management skills.
  • Encourage and support staff members in the pursuit of customer service excellence.
  • Work with team to deliver consistent level of superior customer service.
  • Provide customer service on the use and/or exchange of DME products.
  • Provided excellent customer service and responded to all email inquiries.
  • Provide prompt and courteous customer service to all patient inquiries
  • Displayed excellent customer service skills at all times.
  • Performed voluntary customer service as needed to enhance customer satisfaction -Commended for initiative, customer satisfaction, and dependability.
  • Greeted customers and provided world-class customer service over the phone Verifies and documents all patient's third party payer coverage/non-coverage.

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1 Customer Service Jobs

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5. Data Entry

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high Demand
Here's how Data Entry is used in Insurance Verification Specialist jobs:
  • Performed data entry documenting personal information.
  • Performed clerical duties, such as word processing, data entry, answering phones and filing.
  • General office duties which includes; filing, faxing documents, answering phones and data entry.
  • Handled all data entry for new patients as well as updating existing patient information.
  • Completed data entry task to update all new patient information into the company database.
  • Performed data entry duties to include posting charges at time of service.
  • Performed extensive data entry, organization, and maintenance of corporate files.
  • Complete data entry and appropriate forms to document patients benefit coverage.
  • Performed data entry services such as billing and updating information.
  • Trained new personnel in clerical and data entry positions.
  • Assist with registration overflow and data entry.
  • Verify assigned insurance benefits in a timely manner Data entry in a fast-paced environment with high expectation on accuracy.
  • Verified benefits and eligibility, pre-authorizations, faxing, and data entry.
  • Ensured accurate data entry into healthcare verification applications.
  • Pre-verified medical insurance coverage, hospital intake update, IVR phone/fax/email response, data entry, billing and coding.
  • Perform data entry of patient information, ensuring all documents are accurate and up to date.
  • Call insurance companies and verify DME benefits Data entry of patients demographics Verify all Doctors signatures and dates for processing
  • Ensured insurance denials was reduce, data entry, filing, faxing, and answered multi-lined phones.
  • check, patients insurance,claims, data entry, denials, and adjustments.
  • Initiated the pre-authorizations/pre-determinations for insurance to get verified and processed correctly Ensured accurate data entry into healthcare verification applications.

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5 Data Entry Jobs

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6. Medical Records

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high Demand
Here's how Medical Records is used in Insurance Verification Specialist jobs:
  • Documented patient data and medical records, and performed routine medical record audits to comply with insurance company requirements.
  • Responded to medical record requests and produced medical records for other medical facilities and attorney offices.
  • Conducted retrospective analysis of billing sheets and all collectibles and maintained organization of medical records.
  • Support the patient privacy/confidentiality policies and regulations under HIPAA for patients and their medical records.
  • Utilized Office Facilitator software to locate missing electronic medical records.
  • Maintained medical records, technical library and correspondence files.
  • Maintained confidentiality of medical records.
  • Maintained Medical Records office by bookkeeping, filing, sorting, and charting patients' files.
  • Gather and organize appropriate medical records for lawyers, workers compensations, and insurance requests.
  • Extract information from patients medical records to obtain payable codes for lab charges.
  • Maintained medical records, worked directly with providers to resolve claim issues.
  • Transmit correspondence or medical records by mail, e-mail, or fax.
  • Recorded data and maintained updates in patient s electronic medical records.
  • Requested, located, sent and received patient medical records.
  • Maintained all medical records for patients as per required guidelines.
  • Request medical records from outside facilities and referrals.
  • Scan patient records for electronic medical records.
  • Protect the security of medical records to ensure that confidentiality is maintained.
  • Verified and investigated Medical Records Obtained In/Out/E.R.
  • Helped print out medical records for patients and manager when a project arised

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1 Medical Records Jobs

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7. CPT

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Here's how CPT is used in Insurance Verification Specialist jobs:
  • Verified cardiovascular CPT codes and requested prior authorizations.
  • Provide CPT codes and diagnosis codes when trying to obtain authorizations and referrals for patients scheduled for testing.
  • Provided insurance with CPT codes to see if prior authorization was required and obtained one when applicable.
  • Maximized reimbursement by ensuring accurate ICD-9-CM and CPT coding and following hospital guidelines and HIPPA regulations.
  • Use ICD10, HCPCS, and CPT book on daily basis to submit authorization requests.
  • Worked with Clinical staff to ensure proper CPT and ICD-9 are submitted on authorization requests.
  • Verify that specific CPT/ ICD codes are covered under the patients' policy.
  • Reviewed ICD-9/CPT coding on HCFA-1500 forms to ensured proper billing.
  • Determine and validate CPT and ICD-9 codes same day surgeries.
  • Fax authorization letters, check CPT codes and assess.
  • Verified CPT codes and diagnosis codes with payers.
  • Verify outpatient surgery patients with CPT codes.
  • Experienced in CPT and ICD-9 coding.
  • General knowledge of CPT/ICD-9 codes.
  • Utilize CPT codes, ICD 9 and ICD 10 Codes for correct coding and billing.
  • Full knowledge of CPT codes and DME.
  • Validate and Verification of patients insurances following all guidelines and procedures Medical Coding Specialist/Use of ICD 9 and CPT4 Coding terminology
  • Verify insurance coverage for Radiology exams obtaining deductibles, copays and coinsurance information based on CPT codes.
  • Completed authorization and per-certification for medical treatment for patients who needed special CPT codes approved.
  • verify insurance and obtain pre authoriztion for cpt code

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8. Phone Calls

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high Demand
Here's how Phone Calls is used in Insurance Verification Specialist jobs:
  • Monitor verification representative's phone calls and provide feedback.
  • Verify information through decision making skills and research, which may require minimal outbound phone calls to insurance companies and agents.
  • Provided consistent documentation that reflected the course of events/phone calls made to confirm the benefits, authorizations and co-pay information.
  • Received and made outgoing phone calls to specific clients to verify accuracy of information for various insurance programs.
  • Make and answer phone calls to patients, insurance, providers, nurses, receptionist, etc.
  • Answered, transferred and responded to ER department phone calls and provided general emergency department information.
  • Assist in processing incoming phone calls regarding all aspects of client registration also scheduling client appointments.
  • Routed phone calls to proper therapist, process returned mail and meet with patients family members.
  • Verified member benefits for procedure scheduled via internet resources or phone calls.
  • Answer call center phone calls and emails from residents and responsible parties.
  • Handled telephone calls, took accurate messages and routed them accordingly.
  • Verified insurance, answered phone calls to take messages and set appointments
  • Answer incoming phone calls and make confirmation calls.
  • Answered and screened telephone calls.
  • Accepted incoming patient phone calls and determine patient needs for appointments based upon pre-determined criteria.
  • Answer phone calls, e-mails, and other inquiries from internal and external customers in a timely manner.
  • Answered phone calls, scheduled appointments, confirmed appointments, verified and monitored patients insurance.
  • verified insurance, Answered telephone calls to take messages, Set appointments for patients
  • Answered phone calls Verified Insurance Collected Co-pays Scheduled patients for surgery Discharged patients Faxed and scan papers
  • Present Pre-register patients Verify health insurance Make phone calls to insurance companies Charge entry Posted payments

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9. Patient Demographics

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high Demand
Here's how Patient Demographics is used in Insurance Verification Specialist jobs:
  • Worked closely with front end staff to review uninsured accounts for coverage, including eligibility and entering patient Demographics.
  • Input accurate patient demographics and insurance information into patients files.
  • Verify all patient demographics as well as insurance information.
  • Entered patient demographics at time of scheduling and registration
  • Assisted in answering phones and updating patient demographics
  • Verified and entered patient demographics in system.
  • Update all patient demographics via telephone/fax.
  • Input patient demographics and insurance benefits.
  • Utilize multiple data bases and insurance websites to obtain and verify patient demographics, health benefits, and auto insurance.
  • Verify, apply and maintain accurate patient demographics and insurance information for multiple physician practice, using Medic software.
  • Register patients, file insurance claims, and enter patient demographics into accounts.
  • Worked closely with providers and patients to update and maintain patient demographics.
  • Verify patient demographics, insurance coverage, and benefits.
  • Check and verify patient demographics are true and current.
  • Verify insurance, labs, patient demographics.
  • Update patient demographics and insurance changes.
  • Charge Entry / Insurance Verification Enter patient demographics into a proprietary database.
  • Updated patient demographics to maintain valid contact information.
  • Enter patient demographics in Medinformatix.
  • Verify insurance for new patients, re-verify insurance for returning patients.\ Set up new patient demographics.

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10. Patient Insurance Information

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high Demand
Here's how Patient Insurance Information is used in Insurance Verification Specialist jobs:
  • Verified insurance information by screening patients online or calling insurance companies directly; contacted hospitals for patient insurance information.
  • Prepared and maintained patient insurance information in the data system and coordinated with insurance companies.
  • Updated patient insurance information onto patient's profile and verified patient eligibility.
  • Obtained and verified patient insurance information, including coverage of items.
  • Enter and update patient insurance information, and demographic information.
  • Updated all patient insurance information onto the patient's profile in ScriptMed, the Customer Relationship Management (CRM) System.
  • Entered patient demographics, CPT & ICD-9 codes and patient insurance information in database.
  • Enter all patient insurance information onto the patient's profile.
  • Update patient insurance information in the VA buffer file.
  • Updated patient insurance information in the patient's profile.
  • Updated patient insurance information onto patient's profile Verified health insurance and obtained authorization from various insurance companies for treatment.
  • Verified patient insurance information and checked for precertification status.
  • Updated patient insurance information Coordinated with Referral source.
  • Demonstrated excellent multi-tasking skills when collecting and reviewing all patient insurance information; and updating the system with the new information.
  • Review and enter patient insurance information and collect any copays if apply.
  • Entered data for reports, and patient insurance information into Medisoft.
  • Update patient insurance information onto patient\'s profile.
  • Quote benefits for several Physician offices Resolved denials issues to receive payment Entered patient insurance information accurately in to data base.
  • Obtained appropriate authorizations and/or precertification from insurance payers Setup patient insurance information along with authorization information in the system.
  • Verified and updated patient insurance information and demographics in eCube Financials as appropriate per policy.

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4 Patient Insurance Information Jobs

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11. Scheduling Appointments

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high Demand
Here's how Scheduling Appointments is used in Insurance Verification Specialist jobs:
  • Conducted research and verified patient insurance coverage when scheduling appointments and follow up appointments.
  • Help in radiology scheduling during off season, scheduling appointments, give patient preps and obtain correct Physician orders.
  • Answer patient phone calls prior to them scheduling appointments to confirm demographics and insurance verification.
  • Update the schedule on daily basis by creating, canceling, or rescheduling appointments.
  • Assist in scheduling appointments for multiple doctors (10).
  • Verified Patient's Health Insurance Prior to scheduling appointments.
  • Front Office: Insurance verifications, patient check in and check out, and scheduling appointments.

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12. Durable Medical Equipment

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high Demand
Here's how Durable Medical Equipment is used in Insurance Verification Specialist jobs:
  • Verified insurance coverage for durable medical equipment Data entry Maintained timely communication with 15 designated representatives via email and phone.
  • Handled all insurance verification requests to check eligibility and coverage for patients that required multiple durable medical equipment products.
  • Obtain insurance benefits for Durable Medical Equipment along with authorizations if needed.
  • Verify insurance via portals and telephone for diabetic durable medical equipment.
  • Ensured insurance eligibility for durable medical equipment.
  • Assessed insurance coverage of durable medical equipment.
  • Submit prior authorization for durable medical equipment.
  • Submitted Pre-Authorizations for Durable Medical Equipment.
  • Processed orders for durable medical equipment
  • Reason for leaving: Furthering career Johns Creek, GA Durable Medical Equipment Supplier - Insurance Verification and Authorization Specialist
  • Obtain accurate benefits and eligibility information for durable medical equipment (DME) patients.
  • Accepted payments from insurance companies for services rendered and Durable Medical Equipment.
  • Verified all insurance for a Durable Medical Equipment Company.
  • Verified insurance for durable medical equipment and supplies.
  • Contacted all insurance carriers and verified eligibility and coverage/benefits and Obtained precertification or authorization for renting or purchasing of durable medical Equipment
  • Verified insurance coverage and eligibility for delivery of durable medical equipment in a timely manner.
  • Ensured compliance with applicable standards and regulations Obtained authorization for Durable Medical Equipment
  • Called applicable insurance companies to verify benefits for diabetic testing supplies, durable medical equipment, and ostomy supplies.
  • Verify Medicare , Medicaid, Commercial and Private Insurance for Durable Medical Equipment ...

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13. Patient Care

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high Demand
Here's how Patient Care is used in Insurance Verification Specialist jobs:
  • Entered data pertaining to referrals for non-complex services including inpatient and outpatient care.
  • Communicated with patients and patient care staff regarding insurance coverage limitations and/or requirements.
  • Communicate with Care Coordinator for patient care and medical necessity approval.
  • Assist patient care units with special project management providing supports as it relates to patient access.
  • Subject Matter Expert in Financial Clearance and Revenue cycle process for inpatient and outpatient care.
  • Earned numerous rewards from supervisors for receiving payments, team building and excellent patient care.
  • Researched the best benefits possible for patient care using excellent customer service skills.
  • Assured patient care needs are met and, where possible, exceeded.
  • Assist in financial problem resolution relating to patient care charges.
  • Entered Data entry referrals for non-complex services for outpatient care.
  • Helped coordinate dozens of reports for patient care services.
  • Evaluated current systems to improve operations and patient care.
  • Reviewed incoming referrals and orders for patient care.
  • Coordinate patient care between healthcare providers and insurance carriers for home infusion therapy.
  • Review the patient care and histoy on the computer based system.

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14. Health Care

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high Demand
Here's how Health Care is used in Insurance Verification Specialist jobs:
  • Called private insurance companies, Medicare and Medicaid to obtain benefit information and Determining insurance compatibility with Health care provider.
  • Provide effective communication to patient/family, team members, and other health care professional while maintaining confidentiality.
  • Coordinated and verified patient insurance coverage, and determined insurance compatibility with health care provider programs.
  • Work effectively as part of the health care team, and as an advocate for patients and their families.
  • Processed requests for medical supplies for home health care patients, verifying benefits and eligibility for specific items.
  • Advised medical and dental claim status to Health care providers, including members and other entities.
  • Reviewed medical coding and diagnosis to be in compliance with health care plans and policies.
  • Describe the benefits and coverage associated with different types of health care plans.
  • Verified patient's health insurance with health care providers to for local pharmacy.
  • Discussed eligibility regarding the affordable care act and health care reform.
  • Work with an internet - based health care information system.
  • Enrolled employees in health care plans and answered relevant inquiries.
  • Verified each patient's health care plan and policies.
  • Obtained precertification for procedures needed following physicians orders Ensured patients health care benefits covered the needed procedures requested by physicians
  • Worked to ensure that patients health care benefits cover required procedures.

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15. Patient Accounts

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Here's how Patient Accounts is used in Insurance Verification Specialist jobs:
  • Managed patient accounts for hospital facilities.
  • Updated general information on patient accounts.
  • Maintained patient accounts updated periodically.
  • Review and update patient accounts to ensure PHHS has accurate and current information to process claims and obtain payment.
  • Supported patient billing functions and the management of patient accounts using HIS, PWL and 3M/Encoder Coding System.
  • Shared the responsibility of the daily deposit to the bank and the posting of cash to patient accounts.
  • Process patient accounts and deploy established policies to resolve insurance issues with patient accounts with/without supervision i.e.
  • Monitored payments from various insurance companies to make sure payment is posted on patient accounts.
  • Perform quality assurance checks on patient accounts to ensure the accuracy of reporting and outcomes.
  • Handle calls that come in regarding patient accounts, member eligibility, and office rates.
  • Maintain patient accounts by obtaining, recording, and updating personal and financial information.
  • Set up new patient accounts and update established patient demographics.
  • Have also assisted in basic A/R posting to patient accounts.
  • Update patient accounts and information on a daily basis.
  • Added benefit information to patient accounts.
  • Post payments to patient accounts.
  • Referred patient accounts to Case Management department for clinical justification for pre-authorization as necessary.
  • Set up new patient accounts; verified correct level of physicians diagnosis or services and CPT codes.
  • Assited billing department to collect on patient accounts to increase revenue.
  • Verified outpatient benefits and surgery accounts Insurance verification for medical/diagnostic procedures Updated patient accounts

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8 Patient Accounts Jobs

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16. Outbound Calls

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Here's how Outbound Calls is used in Insurance Verification Specialist jobs:
  • Make outbound calls to verify insurance benefits for Medical and Pharmacy Benefits, Check status of pharmacy prior authorizations
  • Placed outbound calls to various insurance providers to obtain additional information needed for insurance billing.
  • Placed outbound calls to veterans to give information about their schedule appointments and information about what was needed for the appointments.
  • Answer and handle back-to-back inbound calls from client employees as well as conduct outbound calls for follow up as required.
  • Conduct outbound calls to insurance agencies to verify insurance coverage for patients requesting assistance with medical bills.
  • Make outbound calls to different insurance companies to get dates and updated information on all clients.
  • Make outbound calls to patients and insurance companies in order to obtain benefit information.
  • Make outbound calls to insurance carriers and agents to resolve payment and insurance issues.
  • Document inbound/outbound calls along with the nature of request per program specifications.
  • Make outbound calls to agents and insurance companies to get clients information.
  • Handle inbound and outbound calls, transfer clients to appropriate party.
  • Handled heavy inbound/outbound calls in a very fast-paced call center environment.
  • Completed patient benefit verification's through outbound calls to payers.
  • Placed outbound calls to participant and or Dr's offices.
  • Make outbound calls to various carriers to obtain eligibility.
  • Processed 150 outbound calls on a daily basis.
  • Make outbound calls for patient follow up.
  • Handled 100+ inbound/outbound calls daily.
  • Make outbound calls to conduct structured telephone surveys Calculates the up-front cash amount which is collected at time of registration.
  • Fast pace production environment Processing various insurance types claims and carriers Outbound calls Web-based work Third party processor HIPPA Data Entry

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17. Front Desk

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Here's how Front Desk is used in Insurance Verification Specialist jobs:
  • Write down patient balances and credits on daily schedule given to me by collection department before handing it to front desk.
  • Worked closely with scheduling, PAR's, the front desk, and nurses to ensure scheduling.
  • Check in patients at the front desk and collect new and updated insurance and demographic information.
  • Front Desk assistance for the check in and check out process as additional responsibilities.
  • Help assist the front desk with scheduling, payments and product sales.
  • Provided assistance with front desk, registering patients and collecting money.
  • Managed front desk check-in and check-out as well as patient registration.
  • Work independently at the front desk and answer the phones.
  • Help co-workers as needed with other front desk tasks.
  • Front desk check in and check out of patients.
  • Covered the front desk and filed as needed.
  • Assisted front desk in calling patients to confirm surgery date and preparing medical charts for medical records.
  • Handled patient referral request Processed patient payments, co-payments and deductibles at the front desk in other areas
  • Provide front desk staff with accurate balances and copays that must be collected on a daily basis.
  • Act as a back up to Front Desk Ensure all patient demographic and insurance information.
  • Assist patients with insurance questions and concerns Back up support to front desk.
  • Communicate effectively with patients Work closely with the front desk staff.
  • Front Desk Cover front desk lunch daily for two hours.
  • Front desk multi tasker, appointment scheduling, medical records for attorney requests.
  • verify insurance claims follow-up confirm/schedule appointments stock front desk supplies

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18. Hipaa

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Here's how Hipaa is used in Insurance Verification Specialist jobs:
  • Maintained confidentiality of all information; adheres to all HIPAA guidelines/regulations and facility procedures and guidelines.
  • Demonstrate knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
  • Maintained confidentiality concerning clients protected health information in compliance with HIPAA.
  • Maintained patient and family confidentiality as per HIPAA Regulations.
  • Assist leadership in assuring confidentiality is maintained and HIPAA compliance is adhered to with all activities surrounding the patient.
  • Answer phone inquiries from patients and other interested agencies keeping information confidential and per standard of HIPAA law.
  • Trained in HIPAA and compliance requirements in the handling of patient specific protected health information- PHI.
  • Uphold and reinforced compliance with State and Federal regulations such as HIPAA.
  • Maintained patient s confidential information and kept in compliance with HIPAA.
  • Follow all HIPAA, compliance, privacy and confidentiality standards.
  • Adhere to HIPAA guidelines, company privacy and confidentiality policies.
  • Followed HIPAA guidelines, made sure procedures updated accordingly.
  • Verified relevant medical diagnoses while maintaining HIPAA compliance.
  • Processed Medical records following HIPAA Laws.
  • Followed HIPAA regulations for patient privacy.
  • Abided by HIPAA regulations to ensure patient confidentiality.
  • Execute HIPAA privacy guidelines, while using Scriptmed to handle and regulate necessary precautions for patients with carcinogenic illnesses.
  • Communicate with patients and/or referring physicians on non-covered benefits or exam coverage issues Adheres to all HIPAA Guidelines
  • Maintain DD 2569 filing systems that was organized and HIPAA compliant manner all materials needed for audit process and workflow appropriate.
  • Full Time Position Local, state and federal regulatory agencies; extensive knowledge of HIPAA and JCAHO.

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19. HMO

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Here's how HMO is used in Insurance Verification Specialist jobs:
  • Verify insurance for Medicaid, Medicare, HMO/PPO, Commercial, other government payers, and Copay assistance programs.
  • Maintain current knowledge of Medicare, Medicaid, Private Insurance Companies, HMO policies, and PPO policies.
  • Experience working with all payer types: commercial, governmental, Medicare, Medicaid, HMO etc.
  • Reviewed patient registration for accuracy, verified inpatient and outpatient commercial HMO's, Medicare and Medicaid.
  • Verify all insurance for incoming appointments and make sure all patients with HMO insurance had a referral.
  • Verify insurance information, obtain authorizations for HMO, HO patients not obtained prior to visit.
  • Use company website and internet for eligibility, HMO, PPO and many other insurances.
  • Applied HMO knowledge received through training courses to help keep policy holders in compliance.
  • Process all Medicare, Managed Care, and HMO's claims.
  • Provide reports for PCP re-assignment forms for all HMO Plans.
  • Verified and processed billing for private and HMO insurance.
  • Billed Medicare services for the HMO Medicare.
  • Processed patient's insurance, Commercial, Medicare, Medicaid, HMO, PPO, EPO, Work Comp and Liens.
  • Verify medical insurance coverage from government, commercial, HMO or Other third party payers at high volume ambulatory care center.
  • Check eligibility with State funded insurances, Medicare, HMO, PPO, Commercial and Tricare.
  • provide support paperwork and documentation to patients and physicians; maintains awareness of various HMO.
  • Maintained Compliance with all healthcare facility, HMO, and insurance requirements.
  • Verify Insurance Elgibility HMO, PPO, POS & Medicare.
  • involved in coding and entering insurance data for clients ncluding PPO, HMO, Medicare and Medicaid.
  • Subject Expert in Medicare, Medicaid, HMO, Tricare( VA programs).

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20. Insurance Policies

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Here's how Insurance Policies is used in Insurance Verification Specialist jobs:
  • Review dental insurance policies and verify patients eligibility for services offered at participating clinics.
  • Verified and interpreted insurance policies for imaging services rendered in the facility.
  • Handled the collateral protection insurance program by processing forced place insurance policies, working closely with third party agents and members.
  • Notified patients of their financial responsibilities for Co-pays and deductibles according to their health insurance policies.
  • Provided information regarding health insurance policies that may help sell a policy to a customer.
  • Verified medical insurance policies to obtain the earliest effective date of when coverage begun.
  • Finalized and maintained all types of personal lines insurance policies within the agency.
  • Verify health and dental insurance policies of patients that are to be seen.
  • Process new insurance policies, modifications to existing policies, and claims forms.
  • Verified insurance policies via telephone, internet, and faxes for Medicaid.
  • Performed verification of patient's insurance policies for coverage of diabetic supplies.
  • Mentored and trained new team members on hospital insurance policies and procedures.
  • Verified all eligible insurance policies to bill and in proper order.
  • Obtain home health authorizations for insurance policies that require it.
  • Verify insurance policies of patients that are being seen.
  • Process and record new insurance policies and claims.
  • Research health insurance policies using web navigation Handle out bound calls to different insurance carriers to verify customer s policies.
  • Verified health insurance policies for all major commercial carriers, as well as government healthcare agencies.
  • Verified Insurance policies, payments and enrolled participants Assisted participants with payment plans.
  • Verified eligibility-updated all insurance policies .

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21. Hippa

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Here's how Hippa is used in Insurance Verification Specialist jobs:
  • Maintain confidentiality of patient's personal and medical information according to HIPPA regulations.
  • Generated daily reports and maintained strict confidentiality, also HIPPA compliant
  • Contacted policyholders and their doctors' office to obtain required information, such as HIPPA authorization forms, to assist underwriters.
  • Managed electronic public health information (PHI) according to Health Insurance Portability and Accountability (HIPPA) guidelines.
  • Obtained required information from clients, faxed health insurance companies authorization and HIPPA forms signed by clients.
  • Maintained HIPPA Standards and Rights of Privacy for patients entering facilities to receive treatment or services.
  • Assisted members with the application Authorization process, Worked within HIPPA guidelines.
  • Followed all HIPPA guidelines, maintaining strict confidentiality and patient rights.
  • Complied with HIPPA standards in all patient documentation and interactions.
  • Receive incoming calls from customers using PHI and HIPPA standards.
  • Inform new patients about clinic guidelines and HIPPA practices.
  • Educated in keeping patient accounts confidential with HIPPA regulations.
  • Followed HIPPA rules and regulations when discussing patient information.
  • Facilitated medical record requests per (HIPPA) guidelines.
  • Complied with federal regulations, including HIPPA provisions.
  • Provided Medical Records according to HIPPA guidelines.
  • Adhered strictly to HIPPA rules and regulations.
  • Completed, updated and Verified for accuracy any HIPPA and patient acknowledgement forms to be signed by patients upon arrival.
  • Verify Hippa, complete data entry to reflect PA stages.
  • Communicate clearly and effectively -Follows al HIPPAA, compliance, privacy and confidentiality standards -Referrals

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22. Clinical Staff

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Here's how Clinical Staff is used in Insurance Verification Specialist jobs:
  • Worked directly with clinical staff to achieve better processes in achieving proper documentation.
  • Communicate with clinical staff and insurance companies to obtain information and insurance verification.
  • Provide comprehensive administrative support to office manager and clinical staff.
  • Communicated necessary information to clinical staff as needed.
  • Send in-basket messages to clinical staff for authorization
  • Acted as liaison between clinical staff, patients, referring physician offices and various insurance payers.
  • Consult with the patient, physicians and clinical staff regarding the patient insurance criteria.
  • Communicate with home health agencies, clinical staff and billing dept.
  • Work closely with clinical staff and complete daily tasks as assigned.
  • Obtained pre-authorizations from insurance companies and communicated with Clinical Staff.

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23. Timely Verification

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Here's how Timely Verification is used in Insurance Verification Specialist jobs:
  • Provided expert and timely verification for claims, medical visits and back office personnel.
  • Lash Group Insurance verification clerks are responsible for the timely verification of medical insurance benefits.

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24. Payment Arrangements

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Here's how Payment Arrangements is used in Insurance Verification Specialist jobs:
  • Negotiated settlement of accounts and reasonable payment arrangements within corporate guidelines.
  • Coordinated payment arrangements for current and delinquent accounts.
  • Calculate patient cost share and be prepared to collect via phone or make payment arrangements.
  • Set up payment arrangements on an individual case basis.
  • Contacted patient's and set up payment arrangements.
  • Make payment arrangements and setup payment plans.
  • Set patients up for account payment arrangements.
  • Advised patients of deductibles and copays and set-up payment arrangements.
  • Make payment arrangements,solve issues regarding payments etc.
  • Verified patients insurance, pre-certifications, referrals, assisted patients with payment arrangements for schesduled surgeries.
  • Obtain authorization and referrals Assist financial advisor with payment arrangements.

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25. Insurance Plans

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Here's how Insurance Plans is used in Insurance Verification Specialist jobs:
  • Provide quality control by accurately entering insurance plans into practice software and ensuring all details are accurate.
  • Communicate efficiently and effectively with internal and external customers in reference to acceptable insurance plans at HFHS.
  • Supported members and customers by verifying current insurance plans for ordering medications.
  • Work closely with QA Coordinator to train new employees on the authorization processes and identify insurance plans.
  • Verified patient insurance plans via the phone for patients who have appointments at HealthEast facilities.
  • Update patient and family accounts with insurance plans to ensure correct coverage for dependents.
  • Worked closely with customers who had transitional insurance plans become eligible for services.
  • Assist patients with insurance plans to help maintain and lower payments.
  • Reviewed and completed appeals process for denials obtained from insurance plans.
  • Educate members on current and future changes to their insurance plans.
  • Worked with all insurance plans from commercial insurance to Medicaid.
  • Verified all major medical health insurance plans for patients.
  • Submit and Resubmit claims Review and explain insurance plans to patients to guarantee full understanding of payment policies and procedures.
  • Identified referral and authorization requirements of the patients insurance plans by using various on -line resources.
  • communicated with third-party patient insurance plans via phone and internet to gather and verify coverage.
  • Obtained the initial or prior authorizations or pre-certifications required by patients' insurance plans.
  • Assist front desk staff and pre registration staff with questions about insurance plans.
  • Verified patient dental insurance plans -Work with dental insurance companies throughout the US - proficient in Practice Works
  • Obtain initial prior authorization/pre-certification as required by patients insurance plans.
  • Assist Patient with verifications of their insurance plans.. assist with prior authorizations.. adjudicate claims for fullfillment.

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26. Computer System

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Here's how Computer System is used in Insurance Verification Specialist jobs:
  • Demonstrated solid organizational skills in verifying and entering patient demographic and insurance information into computer system.
  • Enter collected information into computer system.
  • Record participant responses into computer system
  • Complete all fields within the computer system necessary to process claims and re-route claim to the billing department per assigned deadline.
  • Obtained accurate demographic, financial and clinical information and enter into the computer system to create the medical and financial record.
  • Ensured that all insurance information needed for billing and collection processes are appropriately obtained and recorded in the computer system.
  • Notified patients of co-payments, deductibles or deposits needed, when applicable, documenting all information in computer system.
  • Obtain benefit information by phone or website to verify patient coverage and enter this information into the computer system
  • Verified, entered, and updated Title 19, Medicare, and commercial insurance information in computer system
  • Verify all data on input to the computer system is accurate in a very fast paced environment.
  • Corrected claims, documented all information in computer system to be billed out.
  • Faxed and scanned documents to appropriate destination in the computer systems.
  • Registered all new patients in to computer system as well.
  • Enter all collected data into appropriate computer system.
  • Put all authorizations in the computer system.
  • Updated the Invision SMS computer system with correct patient information and noted comments about insurance coverage and authorizations.
  • Verify Insurance & load information into the computer system for several different locations within Great Expressions.
  • Input patient data/insurance into computer system for patient to be seen by physician in healthcare center.
  • Entered all authorization and billing information in a timely manner using Meditech computer system.
  • Verify Benefits Data Entry of benefits into computer system Task completed benefits to Case Manager Assist with special projects as requested

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27. Physician Offices

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Here's how Physician Offices is used in Insurance Verification Specialist jobs:
  • Communicated with physician offices regarding insurance coverage, authorizations or possible delay of services.
  • Provided general and specific information to hospitals, patients, laboratories and physician offices.
  • Communicated with physician offices on a daily basis to verify patient information.
  • Contacted physician offices for procedure and medication authorizations as needed.
  • Contacted physician offices for missing patient information and diagnosis.
  • Coordinated with physician offices for procedure & medication authorizations.
  • Worked directly with physician offices to secure authorizations.
  • Communicated with physician offices and insurance companies.
  • Resolved various appointment / insurance issues in a very timely matter to the great satisfaction of many patients and physician offices.
  • Obtained complete and accurate financial information from a variety of sources, including patient interviews and physician offices.
  • Communicate with physician offices to receive requests and resolve problems; notify consumers and physicians of discrepancies.
  • Verify claims with employers, insurance companies, physician offices, and patients via telephone and fax.
  • Answer incoming calls from Physician offices, patients and various payers.
  • Contacted & built rapport with physician offices for authorization/ referral requests.
  • Handled calls for patients, physician offices, and/or insurance companies.
  • Worked with physician offices and insurance companies to complete prior authorizations.
  • Communicate with physician offices as it relates to patients orders.
  • Contacted physician offices for procedure and medication authorizations as needed Investigated and resolved queries and complaints pertaining to urgent orders.
  • Discussed authorization issues with physician offices, payors, and hospital and non-hospital personnel.
  • Follow up with Physician offices as needed for any descrepancies.

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28. EMR

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Here's how EMR is used in Insurance Verification Specialist jobs:
  • Organized with documents and entering information into EMR using EclinicalWorks.
  • Provided medical record support in the absence of EMR: assisted clinics and hospitals in obtaining medical records in appropriate format.
  • Experienced trainer for resource staff, current experience with EMR system, designated Super User/Trainer for EPIC computer system.
  • Maintained patient documentation within electronic medical records (EMR) systems in strict adherence to HIPAA regulations.
  • Assisted in new system and EMR conversion for physical therapy and home health companies.
  • Trained employees on monitoring and maintain PQRS scores for Medicare reporting using EMR dashboard.
  • Reviewed medical records via online EMR system QuadraMed, extracting clinical data as needed.
  • Schedule new and current patients into EMR for specified procedure by ordering physician.
  • Pulled and submitted medical records and paper claims using EMR.
  • Entered coverage data into EMR and billing system.
  • Created accounts for each patient in EMR.
  • Updated patient information in EMR system.
  • Document patient information on EMR system.
  • Input data entry into EMR.
  • Complete the Insurance Benefits Verification form in the EMR (ARTworks) and record it on the date of the verification.
  • Arrange schedule in EMR for EGD, Colonoscopy, Pain Management, and General Surgery.
  • Possessed broad EMR and medical software experience through Centricity, GE.
  • Use the following systems daily; Availity, EMR, and Allscripts.
  • Check in/out -Billing -Setting up appointments -Setting OB Contracts -Checking Eligibility -EMR Scanning -Authorizations -Verification of benefits for visits/procedures/surgery

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29. Primary Care Services

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30. EOB

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Here's how EOB is used in Insurance Verification Specialist jobs:
  • Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts
  • Provided EOB's to Medical Offices, Specialists, and Patients.
  • Experience with coding and billing guidelines, and EOB's.
  • Verified patient insurance coverage, EOB and LOA on file.
  • Speak to billing department to resolve patient issues regarding EOB.
  • Apply EOB information from insurance companies to patient accounts.
  • Experience in payment posting of EOB's.
  • Researched EOB rejections and other issues.
  • Updated patient accounts from EOB received.
  • Review EOB insurance collection follow up
  • Submit Claims to Insurance companies recieveing payment and EOB's input into the system.
  • Review EOBs for line-by-line application of payments to patient charges.
  • Post denials for EOBs received from Insurance Companies.
  • Work with EOBs and matching posted payments.
  • Analyzed EOBs with insurance companies for investigation.
  • Post payments to patient accounts in MediSoft from EOB's, Simple ERA, InsVerify and Ingenix (electronic posting).
  • Account Receivable Assisted clients with EOB's Resolving account Balances
  • Charge entry Data and patient entry Follow up on insurance claims/ payments EOB postings Verification of Insurance benefits
  • Experience in cash posting and reviewing EOB's Scaned documents Faxed papers Copy documents
  • Check Claim status Insurance Verifications Patient Inquries File (EOB) Post Payments Submit corrected claims/Recons Update Billing information

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31. MRI

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Here's how MRI is used in Insurance Verification Specialist jobs:
  • Help open and oversee day to day operations for patient access at the Walden MRI & X-ray center in Bonita Springs.
  • Assisted to spearhead RADSTAR, a radiology scheduling department within OMI, to filter MRI and CT scans into the company.
  • Submit requests for authorizations to insurance companies for MRI's, CT's and surgical procedures.
  • Obtained authorizations for MRI's, registered patients at appointment time and over the phone.
  • Work rotating Saturday's handling the MRI patient registration check in.
  • Prepare verifications for 25 Magnetic Resonance Imaging (MRI) centers in preparation for the patients' time of service.
  • Obtain benefits for MRI, CT, NCV, DEXA bone density, Ultrasounds, Nuclear scanObtain Preauthorization and predetermination Icd9Light scheduling
  • initiated the pre-authorizations/pre-determinations, CT/MRI for insurance to get verified and processed correctly.

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32. Necessary Procedures

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Here's how Necessary Procedures is used in Insurance Verification Specialist jobs:
  • Verify patient insurance coverage, to ensure necessary procedures are covered by an individual s provider.
  • Verified patient insurance coverage through commercial and workers compensation, to ensure necessary procedures are covered.
  • Verified patient insurance coverage, to ensure necessary procedures are covered.
  • Ensured necessary procedures are covered by an individual s provider.
  • Verify patient insurance coverage with various insurance companies to ensure necessary procedures are covered by the patient s provider.
  • Obtain any authorizations, or referrals that are needed for the necessary procedures.

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33. Providers

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Here's how Providers is used in Insurance Verification Specialist jobs:
  • Provided direct support to Primary Care practices and specialty care providers regarding C utilization, authorization, and referral activities.
  • Scan and upload documents from insurance providers into electronic records system and notify appropriate departments.
  • Received incoming calls from patients and medical providers, verified eligibility and benefit coverage.
  • Facilitate connection to outside service providers if clients are not financially eligible.
  • Organize clinical data to assist providers with prior authorization insurance approval.
  • Verified eligibility of members and participating status of providers.
  • Research all information needed to complete the billing process and obtain information from physicians and providers.
  • Obtain prior authorizations/referrals from payers and notify providers as well as patients of benefit details.
  • Help prepare invoices to patients and insurance providers to ensure rapid payment for the services.
  • Verified patient dental coverage for 5 local dental offices and multiple providers.
  • Logged providers' participation for updates on company- wide Excel spreadsheet.
  • Received inbound calls from all different providers and members.
  • Followed up with decisions from providers.
  • Communicated coordination of benefits issues with providers and members Identified system problems and reported them to supervisor.
  • Managed difficult and sensitive situations Utilized my communication and organization skills, liaison between hospital client and providers
  • Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
  • Verified medical insurance benefits for over 10 providers including specialty physicians in a timely manner.
  • Contacted insurance providers to verify correct insurance information and get authorization for proper billing codes.
  • Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner.
  • ontacted providers with authorization, denial, and appealed process information.

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34. High Volume

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Here's how High Volume is used in Insurance Verification Specialist jobs:
  • Verify insurance prior to patients surgery or procedure for high volume surgical facility center.
  • Demonstrated leadership skills that enable the processing of high volumes of patient information to achieve revenue generation goals.
  • Answered high volumes of inbound calls, providing customer service to patients with appointment inquiries and pricing concerns.
  • Assisted the Insurance Verification Team when there was a high volume of work to be completed.
  • Performed a high volume of out-bound calls to insurance companies to obtain benefits information.
  • Responded to high volumes of telephone inquiries with friendliness and professionalism.
  • Receive inbound calls in a high volume call center.
  • Worked in a high volume call center environment.
  • Deal with high volume of data processing.
  • Verified insurance coverage amounts and completed pre-certifications for high volume cancer imaging offices.
  • Worked in a high volume, fast-paced inbound call center environment Identifies key, recurring issues across the department.
  • Complete high volume data entry expeditiously and accurately, clearing out task queues in a timely manner.
  • Multi-tasked in a high volume, fast-paced environment.
  • Answer a high volume of phone calls Assist in completing charts and documents Use of Salesforce Proficient in computer software.

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35. Diagnosis Codes

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Here's how Diagnosis Codes is used in Insurance Verification Specialist jobs:
  • Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.
  • Communicated with nurse care managers providing HCPCT codes and diagnosis codes in order to obtain proper authorization.
  • Collect any clinical information such as lab values, diagnosis codes, etc.
  • Input procedure codes and diagnosis codes for each encounter form.
  • Verify insurance eligiblity and benefits using ICD10 and diagnosis codes.
  • Request appropriate adjustments based on contract, modifiers or appeal denials Charge entry of Procedures Codes, ICD9 diagnosis codes.

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3 Diagnosis Codes Jobs

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36. Medical Billing

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Here's how Medical Billing is used in Insurance Verification Specialist jobs:
  • Enter all insurance information clearly and accurately into two medical billing systems.
  • Worked for an independent billing company handling electronic medical billing and collections.
  • Developed knowledge of medical billing.
  • Trained new employees on multiple medical billing programs, data entry software, and insurance verification techniques.
  • Exercised proficiency with ICD-9 Coding for medical billing systems.
  • Handle some medical billing issues working closely with the medical billers.

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4 Medical Billing Jobs

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37. Medical Necessity

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Here's how Medical Necessity is used in Insurance Verification Specialist jobs:
  • Communicated with managers and staff regarding medical necessity for authorizations and reminders on authorization expiration.
  • Audited new customer files to verify medical necessity and satisfaction of coverage criteria.
  • Faxed and emailed letters of medical necessity to insurance for authorizations.
  • Verified medical necessity and coordinated with Clinicians to obtain updated information.
  • Obtain medical records and submit successful appeals for medical necessity denials.
  • Obtain clinical and/or medical records for review of medical necessity.
  • Obtained letter of medical necessity or physician orders if required.
  • Faxed and emailed LOMN (letter of medical necessity) with clinical notes to provider for authorizations
  • Send all relevant documentation to insurance companies to support medical necessity for home health services.
  • Created new cases for nurse review, obtained Patient's Clinical for medical necessity review.
  • Obtained pre- authorizations or letter of Medical Necessity.
  • Screen physician's orders and pre-registration data for changes and compliance with payer requirements for medical necessity and pre-certification.

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3 Medical Necessity Jobs

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38. Patient Files

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Here's how Patient Files is used in Insurance Verification Specialist jobs:
  • Ensured all inpatient files are available for daily verification of insurance benefits by printing census.
  • Maintained and updated insurance information for all patient files.
  • Process, organize, and file patient files.
  • Create patient files based off of patient insurances.
  • Input data and make corrections to patient files.
  • Create and maintain patient files.
  • Maintained and updatedinsurance information for all patient files.
  • Handled all Aetna, m-health, bcbs claims denials & rejections Maintained and updated insurance information for all patient files.
  • Greet patients Verify Insurance Make patient files Answering phone

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39. Surgical Procedures

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Here's how Surgical Procedures is used in Insurance Verification Specialist jobs:
  • Obtain eligibility of benefits and authorization of insurance for patients regarding surgical procedures/ in office procedures.
  • Contacted insurance providers to verify patient eligibility and benefits for surgical procedures via telephone and/or internet.
  • Verified insurance eligibility and benefits for scheduled surgical procedures, diagnostic testing, and inpatient admissions.
  • Coordinated with various outpatient facilities and hospitals for posted surgical procedures.
  • Verify insurance coverage for all outpatient surgical procedures.
  • Entered data, demographics, insurance, financial, medical, and other patient profile databases to set up surgical procedures.
  • Obtained information from major insurance companies on co-pays, deductibles, and co-insurance rates for surgical and non-surgical procedures.
  • Verified patients insurances for day to day visits & surgical procedures.
  • Schedule surgical procedures as needed.
  • Verified insurance benefits and eligibility and authorizations and referrals for surgical procedures .
  • Obtained authorization for all surgical procedures .
  • Obtained precertification prior to surgical procedures.
  • Informed patients of health coverage responsibilities in regards to office visits and surgical procedures.
  • Estimated patients out of pocket expenses prior to surgical procedures.

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40. Additional Information

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Here's how Additional Information is used in Insurance Verification Specialist jobs:
  • Utilized initial referral form to determine if additional information will be needed in order to complete verification of benefits.
  • Submit appeals, reconsideration, respond to inquiries from payers needing additional information for payment adjudication.
  • Communicated with other doctor's offices are needed regarding additional information needed for referrals/authorization request
  • Communicated any financial responsibilities and additional information necessary for processing the insurance.
  • Flagged the patients that benefits could not be verified to make the PSR aware that additional information is needed for verification.
  • Ensured data elements that were required for patient billing, and insurance claim submission are satisfied without additional information.
  • Follow up with the Front Office regarding pending accounts or to obtain additional information.
  • Request additional information such as referrals, scripts, and medical records.
  • Contacted referral sources, patients, or doctor's offices to obtain additional information required to complete verification of benefits.

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41. Physical Therapy

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Here's how Physical Therapy is used in Insurance Verification Specialist jobs:
  • Contacted physician offices to obtain referral as needed for physical therapy evaluation and treatment.
  • Verified patient's insurance eligibility for chiropractic and physical therapy treatment.
  • Verified and entered physical therapy and medical benefits.
  • Collaborate with Physicians Physical Therapy Service team, which provides physical therapy services in 5 different locations.
  • Verify insurance for physical therapy benefits, reply to clinic emails, and update 15 minute report
  • Scheduled appointments, check-in, check-out, clerical duties for the Physical Therapy unit.
  • Code and bill out office visits, physical therapy and MRI's.
  • Verified insurances for MRI, Physical Therapy and Worker's Compensation.
  • Request medical and physical therapy notes.
  • Admitted and discharged patients for physical therapy, verified accuracy of insuranceinformation, approved insurance eligibility and collected payments.
  • Verify current benefit coverages for physical therapy for new and existing patients.
  • Verified patient's health insurance and obtained authorization from various insurance companies for Mri's, Cat Scans and Physical Therapy.
  • Managed and posted payments Physical Therapy MSA, Worker's Comp, BC/BC, Tricare, and Commercial Accounts.
  • Verify benefits for dme, injections, mri, xray, office visit, out patient surgery, and physical therapy.

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42. Icd-10

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Here's how Icd-10 is used in Insurance Verification Specialist jobs:
  • Check CPT and ICD-10 codes with LCD and policies from multiple insurance companies to make sure procedures will be paid.
  • Verify insurance through the internet or via telephone using diagnosis codes and ICD-10 codes.
  • Obtained medical benefits for physician offices, including referral & pre-authorizationinfo for specific CPT & ICD-10 codes.
  • Maintained working knowledge of CPT, ICD-9, ICD-10 coding principles and Hipaa guidelines.
  • Initiated any required pre-certification/referrals for the correct CPT and ICD-10 codes in a timely manner and followed up if needed.
  • Attended numerous trainings with insurance companies and ICD-10 trainings.

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43. Billing Department

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Here's how Billing Department is used in Insurance Verification Specialist jobs:
  • Position included verifying insurance eligibility and coverage with insurance companies and coordinating with scheduling and insurance billing departments.
  • Communicate with Customer Service and billing department to obtain additional insurance information and identify.
  • Verified PIP coverage and No Fault insurance as part of a role in liaising between the billing department and MVA/WC department.
  • Provided education and support to Billing Departments, Ambulatory Care Center staff, OSU Medical Staff and others.
  • Work closely with billing department to ensure all information is correct and that monthly goals are met.
  • Assisted Billing Department staff with patient account discrepancies and allocated collected funds to proper patient accounts.
  • Worked alongside with the billing department, on outstanding claims from previous visits.
  • Work in partnership with billing department regarding unpaid claims and denials of claims.
  • Configured pricing template to send to billing department for billing to insurance.
  • Assisted the billing department in entering claims into the computer program.
  • Review with team for overall operations of the billing department.
  • Assist patients, reception and the billing department when needed.
  • Verify insurance and work closely with the billing department.
  • Provide support to the billing department when needed.
  • Assist with the billing department.

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44. Outpatient Procedures

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Here's how Outpatient Procedures is used in Insurance Verification Specialist jobs:
  • Obtain benefits and authorization for inpatient and outpatient procedures by working with specialists secretary's and other designated personal.
  • Determined prior authorizations for medication and outpatient procedures.
  • Obtained authorizations for inpatient admissions and outpatient procedures.
  • Obtained authorization on all office/outpatient procedures and surgeries.
  • Register patient for admission and outpatient procedures.
  • Registered patients for inpatient/outpatient procedures.
  • Obtained various proper authorizations or referrals required prior for office visits, office testing, and outpatient procedures.
  • Verify insurance for inpatient stay & outpatient procedures as needed.
  • Verify all inpatient and outpatient procedures and surgeries.
  • Obtain authorizations for in or outpatient procedures.
  • Registered patients for high tech radiology procedures, processed pre-authorizations for outpatient procedures.
  • Verified insurance for outpatient procedures Collect co-pays/deductibles for procedures from patients
  • Verified insurance for gastroenterology outpatient procedures.
  • registered patients for their outpatient procedures.
  • Obtain initial prior authorization, precertification, benefits for home sleep study and outpatient procedures.
  • Obtain prior authorizations for office/outpatient procedures Ensure proper cob for billing purposes Properly interprete insurance eob for patient/insurance responsibility.

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46. Icd-9

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Here's how Icd-9 is used in Insurance Verification Specialist jobs:
  • Utilized ICD-9 and CPT codes as well as patient clinical information in order to obtain expedited and accurate billing.
  • Contacted insurance companies to obtain surgery benefits, authorizations and eligibility while identifying ICD-9 codes and CPT codes.
  • Input and fulfill prescription orders by verifying insurance coverage and pricing using TurboCap and ICD-9 coding.
  • Enter CPT and ICD-9 Codes for all surgical procedure done within our clinic and hospital.
  • Maximized reimbursement from insurance companies by ensuring accurate ICD-9 and CPT coding.
  • Apply ICD-9 and CPT coding to warrant payment for Medicare outpatient testing.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
  • Apply ICD-9 and CPT codes to procedures performed.
  • Research and process ICD-9, CPT, and HCPCS codes.
  • Experience with ICD-9 and CPT Coding.
  • Verified and preauthorized all surgery cases, and the equipment needed, with icd-9 codes prior to surgery.
  • Verified CPT and ICD-9 codes with Insurance carrier for surgery approval for Bolingbrook & GlenOaks Hospital.
  • Obtained authorization for services being rendered per HCPC and ICD-9 codes via units of measurment.
  • Adjusted balances for patients and PBMs and ensured the correct ICD-9 codes were input.
  • Input (CPT, ICD-9, HCPC) medical coding into pre-certification cases.
  • Multi-faced computer applications utilizing ICD-9 Coding, CPT Coding.
  • Provide to the Insurance the ICD-9 and CPT codes for Out-Patient, Clinical and Admission To have the authorization for procedures..

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47. Insurance Authorizations

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low Demand
Here's how Insurance Authorizations is used in Insurance Verification Specialist jobs:
  • Obtained insurance authorizations for office visits and surgical procedures and instructed patients in protocol for procedures.
  • Obtain patient insurance authorizations with Physicians orders, requesting extensions on medications orders.
  • Acquired insurance authorizations for procedures and tests ordered by the attending physician.
  • Follow through with insurance authorizations before procedure was preformed.
  • Retrieved patient past balances and insurance authorizations.
  • Verified necessary physician referrals and insurance authorizations.
  • Initiate and obtain insurance authorizations and referrals.
  • Get all the proper insurance authorizations' for physical therapy and/or other services.
  • Confirm insurance authorizations prior to procedures; follow up on denied claims.
  • Initiate and track all insurance authorizations and referrals.
  • Obtain insurance authorizations and/or pre-certifications and verify insurance coverage and benefits.

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48. Party Payers

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low Demand
Here's how Party Payers is used in Insurance Verification Specialist jobs:
  • Utilized available technology and resources in order to remain knowledgeable of changing guidelines and regulations of third party payers.
  • Ensured compliance with State and Federal Laws Regulations for Managed Care and other Third Party Payers.
  • Prepare and mail billing statements; Submit claims to insurance companies and other third-party payers.
  • Prepare accurate clean claims and submit to third party payers, including Medicaid and Medicare.
  • Provided excellent customer service when working with physician offices, third party payers and patients.
  • Verified insurance through online systems ranging from managed health care to third party payers.
  • Updated and verified all data for the patient and third-party payers.
  • Follow up with third party payers regarding payment of claims.

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49. Financial Statements

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low Demand

50. Bcbs

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low Demand
Here's how Bcbs is used in Insurance Verification Specialist jobs:
  • Worked closely with Medicare, Medicaid, BCBS, Cigna, Aetna, and United Healthcare and Billing Department.

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Insurance Verification Specialist Jobs

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20 Most Common Skills For An Insurance Verification Specialist

Insurance Companies

50.2%

Medical Procedures

6.0%

Medicaid

5.0%

Customer Service

4.9%

Data Entry

4.2%

Medical Records

3.8%

CPT

2.9%

Phone Calls

2.7%

Patient Demographics

2.4%

Patient Insurance Information

2.3%

Scheduling Appointments

2.1%

Durable Medical Equipment

1.8%

Patient Care

1.8%

Health Care

1.7%

Patient Accounts

1.6%

Outbound Calls

1.6%

Front Desk

1.4%

Hipaa

1.3%

HMO

1.2%

Insurance Policies

1.2%
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Typical Skill-Sets Required For An Insurance Verification Specialist

Rank Skill
1 Insurance Companies 41.1%
2 Medical Procedures 4.9%
3 Medicaid 4.1%
4 Customer Service 4.0%
5 Data Entry 3.4%
6 Medical Records 3.1%
7 CPT 2.3%
8 Phone Calls 2.2%
9 Patient Demographics 2.0%
10 Patient Insurance Information 1.8%
11 Scheduling Appointments 1.7%
12 Durable Medical Equipment 1.5%
13 Patient Care 1.5%
14 Health Care 1.4%
15 Patient Accounts 1.4%
16 Outbound Calls 1.3%
17 Front Desk 1.2%
18 Hipaa 1.1%
19 HMO 1.0%
20 Insurance Policies 0.9%
21 Hippa 0.9%
22 Clinical Staff 0.9%
23 Timely Verification 0.9%
24 Payment Arrangements 0.9%
25 Insurance Plans 0.9%
26 Computer System 0.8%
27 Physician Offices 0.8%
28 EMR 0.8%
29 Primary Care Services 0.7%
30 EOB 0.6%
31 MRI 0.6%
32 Necessary Procedures 0.6%
33 Providers 0.6%
34 High Volume 0.6%
35 Diagnosis Codes 0.5%
36 Medical Billing 0.5%
37 Medical Necessity 0.5%
38 Patient Files 0.5%
39 Surgical Procedures 0.5%
40 Additional Information 0.5%
41 Physical Therapy 0.5%
42 Icd-10 0.5%
43 Billing Department 0.5%
44 Outpatient Procedures 0.5%
45 Navinet 0.5%
46 Icd-9 0.4%
47 Insurance Authorizations 0.4%
48 Party Payers 0.4%
49 Financial Statements 0.4%
50 Bcbs 0.4%
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16,986 Insurance Verification Specialist Jobs

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