Job Description This is a remote position.
40 hours per week Mon - Fri 8 AM- 5 PM Georgia, US Time includes 1h unpaid break.
Job Summary : The Insurance Verification Specialist is responsible for ensuring the accuracy and completeness of insurance coverage information for patients.
This role plays a vital part in the revenue cycle process by verifying benefits, securing authorizations, and resolving coverage issues to facilitate timely payment for services rendered.
Key Responsibilities : Insurance Verification : Confirm patient insurance eligibility and benefits through online portals, phone calls, or electronic systems.
Identify coverage limitations, deductibles, co-pays, and out-of-pocket responsibilities.
Authorization Management : Obtain pre-certifications and prior authorizations for scheduled procedures or treatments.
Track and follow up on pending authorizations to avoid delays in patient care.
Patient Communication : Inform patients of their insurance coverage, out-of-pocket costs, and any issues with their policy.
Address patient inquiries regarding insurance verification in a professional and empathetic manner.
Documentation and Records : Accurately input verified insurance information into the patient management system.
Maintain detailed records of verification and authorization activities.
Collaboration : Work closely with clinical, billing, and scheduling teams to resolve discrepancies or coverage issues.
Liaise with insurance companies to clarify coverage details and resolve conflicts.
Compliance : Ensure adherence to HIPAA regulations and company policies when handling sensitive patient information.
Stay updated on changes in insurance policies and guidelines.
Qualifications : Education : High school diploma or equivalent; post-secondary education in healthcare administration is a plus.
Experience : Previous experience in insurance verification, billing, or a related healthcare field preferred.
Familiarity with medical terminology and coding (CPT, ICD-10) is advantageous.
Skills : Strong attention to detail and accuracy.
Excellent communication and interpersonal skills.
Proficiency in using insurance portals, EMR/EHR systems, and Microsoft Office Suite.
Ability to work in a fast-paced environment and manage multiple tasks.
Key Competencies : Problem-solving and critical-thinking skills.
Time management and organizational skills.
Team-oriented mindset with a customer-focused approach.
Requirements Key Responsibilities: Insurance Verification: Confirm patient insurance eligibility and benefits through online portals, phone calls, or electronic systems.
Identify coverage limitations, deductibles, co-pays, and out-of-pocket responsibilities.
Authorization Management: Obtain pre-certifications and prior authorizations for scheduled procedures or treatments.
Track and follow up on pending authorizations to avoid delays in patient care.
Patient Communication: Inform patients of their insurance coverage, out-of-pocket costs, and any issues with their policy.
Address patient inquiries regarding insurance verification in a professional and empathetic manner.
Documentation and Records: Accurately input verified insurance information into the patient management system.
Maintain detailed records of verification and authorization activities.
Collaboration: Work closely with clinical, billing, and scheduling teams to resolve discrepancies or coverage issues.
Liaise with insurance companies to clarify coverage details and resolve conflicts.
Compliance: Ensure adherence to HIPAA regulations and company policies when handling sensitive patient information.
Stay updated on changes in insurance policies and guidelines.
Qualifications: Education: High school diploma or equivalent; post-secondary education in healthcare administration is a plus.
Experience: Previous experience in insurance verification, billing, or a related healthcare field preferred.
Familiarity with medical terminology and coding (CPT, ICD-10) is advantageous.
Skills: Strong attention to detail and accuracy.
Excellent communication and interpersonal skills.
Proficiency in using insurance portals, EMR/EHR systems, and Microsoft Office Suite.
Ability to work in a fast-paced environment and manage multiple tasks.