Medical Insurance Verification Specialists

Description

Key Responsibilities

• Verify patient insurance coverage and benefits for medical procedures and services.
• Ensure that the office is authorized to bill the insurance company for services provided.
• Review insurance policies and coverage limitations to ensure that patients are aware of any out-of-pocket costs.
• Work with patients, insurance providers, and office staff to resolve billing and insurance-related issues.
• Document and maintain accurate records of all insurance verification activities.
• Collaborate with credentialing and revenue cycle management staff to ensure timely and accurate billing of
  services provided.
• Maintain knowledge of existing and emerging regulatory changes and how they impact operational processes
  and beyond.
• Participates in the development of coding and billing strategies, evaluating processes related to Revenue Cycle and making recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA,
  Medicaid, Medicare, and specific 3rd Party Payors).
• Participate in departmental meetings as required by revenue cycle management leadership

Skills, Knowledge & Expertise

• More than a year of previous experience in medical insurance verification or related field preferred.
• Knowledge of medical terminology, insurance procedures, and billing codes.
• Strong attention to detail and accuracy.
• Must be able to maintain HIPAA compliance in a remote setting.
• Excellent communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Proficiency in using computers and software applications, including Microsoft Office and electronic medical record (EMR) systems.

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