Insurance Verification Coordinator I - 590069

Insurance Verification Coordinator I - 590069

• High school diploma with 1+ years of medical billing or insurance verification experience.
  
• A Bachelor's degree in a related field may substitute for experience.
  
• Experience working with payors and prior authorizations preferred.
  

• Obtain and verify insurance eligibility for services provided and document complete information in the system.
  
• Perform prior authorizations as required by payor sources, including obtaining necessary documentation through collaboration with physician offices and insurance companies.
  
• Collect clinical information such as lab values, diagnosis codes, etc.
  
• Determine patients' financial responsibilities as outlined by insurance plans.
  
• Configure coordination of benefits information for every referral.
  
• Ensure assignment of benefits is obtained and on file for Medicare claims.
  
• Bill insurance companies for therapies provided.
  
• Document all relevant communication with patients, physicians, and insurance companies as it relates to collection procedures.
  
• Identify and coordinate patient resources related to reimbursement, including copay cards, third-party assistance programs, and manufacturer assistance programs.
  
• Handle inbound calls from patients, physician offices, and/or insurance companies.
  
• Resolve claim rejections related to eligibility, coverage, and other issues.
  
• Perform other duties as assigned.
  
• Comply with all policies and standards.
  

• Perform insurance verification for medications.
  
• Handle prior authorization appeals.
  
• Communicate with patients, doctors' offices, and insurance plans.
  
• Manage inbound internal queue.
  
• Process 25+ referrals per day.
  
• Maintain 95% quality or higher.
  
• Attendance is crucial.
  

• Obtaining benefits directly from health plans and providing information to patients.
  
• Submitting prior authorizations independently.
  

• Direct benefit verification experience.
  
• Prior authorization submission experience.
  
• Professional presentation.
  

• Required: High school diploma
  
• Preferred: N/A
  

• Required: N/A
  
• Preferred: N/A
  

• Required: 1+ years of relevant experience
  

• Proficiency in Microsoft Office
  
• Backgrounds that perform well in this role include: Managed Care, Pharmacy, Medical Terminology, Physician Office Experience, Customer Service, and Call Center environments.
  

1. Managed Care
   
2. Customer Service
   
3. Call Center
   

Interested candidates please send resume in Word format Please reference job code 250112 when responding to this ad.