Insurance Verification & Authorization Specialist

Insurance Verification & Authorization Specialist

Requirements

• Knowledge of Commercial, Medicare and Medicaid Insurance guidelines.
• Experience working with insurance payer sites such as Medicaid, Medicare, and private insurance carriers.
• Excellent mathematical skills, computer skills, Google suite application skills.
• Excellent verbal and written communication skills.
• Ability to prioritize and manage multiple workflows and responsibilities.
• Strong attention to detail and goal oriented.
• Ability to work in a results-oriented and fast-paced environment, both individually and as part of a team.

Responsibilities

• Verify healthcare insurance benefits by utilizing payer portals and making phone calls to insurance companies.
• Calculate and provide estimated patient responsibility for scheduled services.
• Obtain referrals and authorization for patient care.
• Collaborate with Front Desk, Scheduling, and Clinical Operations teams to complete assigned tasks.
• Monitor voicemail to properly follow-up with patient inquiries in a timely manner.
• Communicate with patients and Aspire staff regarding out-of-pocket cost estimates and financial responsibility as well as authorization requirements.
• Review demographic and insurance information in patient accounts and make necessary corrections.
• Follow policies and procedures to contribute to the efficiency of the business office.
• Complete accurate and timely insurance verification for patient visits/procedures/testing in accordance with company policy, workflow, and department goals.
• Complete accurate and timely third-party payer authorization requests, including ensuring all necessary data elements needed for an authorization (e.g., CPT codes, diagnosis codes) are available.
• Ensure services scheduled by the scheduling team have approved authorization as required by payer and procedure prior to service.
• Refer underinsured/uninsured patients to the Billing Specialists to see if the patient is eligible for assistance or offer payment options prior to services being received.
• Create a positive patient experience by being polite, compassionate, and professional.
• Provide cross-coverage and training, when needed, for other team members.
• Maintain productivity and quality performance expectations.
• Review and meet ongoing competency requirements of the role to maintain the skills, knowledge, and abilities to perform, within scope, role specific functions.

Preferred Qualifications

No preferred qualifications provided.