Insurance Verification Spec

High school graduate or equivalent
Enthusiastic, friendly, patient focused customer service skills
Exemplary communication skills, written and verbal
Professional, effective communication skills required to contact insurance companies
Must be a team player with ability to collaborate interdepartmentally and with clinical staff
Capacity to multi-task with computer programs while providing patients the highest level of care and attention
Works well in a team environment to accomplish common tasks to solve problems and enhance the smooth and efficient flow of the department
Minimum of 1 year experience with hospital insurance plans including Medicare, Medicaid, HMO’s, and PPO’s
Excellent typing and computer skills
Familiarity with area managed care plans and contractual terms
Ability to self-direct and exercise independent judgment in situations requiring follow-up and discussions with clinical staff and/or other areas of Patient Access
Minimum of 1 year of specialized training in a health care setting with demonstrated knowledge of insurance verification and working knowledge of authorization and pre-certification process preferred
Familiarity with medical terminology

Delivering a dynamic customer experience to all customers
Initiates contact with insurance companies for verification of benefits
Utilizes electronic scheduling/pre-registration/financial systems, payer’s websites, and recorded calls to validate patient’s health coverage and benefits
Review and verify all insurance plans and confirm patient’s eligibility and benefits
Communicate with insurance carriers for insurance verification, obtaining patient benefits and/or follow up
Verify whether the plan coverage is Primary or Secondary, HMO, PPO or Commercial Carrier Insurance
Verify plan coverage including deductibles and co-pays and the status of payment requirements
Verify the out-of-network requirements/benefits for each patient
Verify insurance for emergency and walk-in patients as requested
Maintain proper insurance verification documentation in the patient’s medical record
Input or update any demographic, insurance information, referrals, patient management, documentation into electronic file
Contacts and communicates all applicable insurance deductible, co-pay, arrival and procedure information and instructions to the patient prior to arrival
Identify patient financial responsibilities and collect applicable payment
Maintains the confidentiality of patient’s records and any related work
Performs other duties as assigned

Minimum of 1 year of specialized training in a health care setting with demonstrated knowledge of insurance verification and working knowledge of authorization and pre-certification process preferred