Insurance Verification Specialist

    Highlights

    General Summary: Review each day’s schedule and verify insurance, updating patient and insurance demographics, and ensuring any necessary referrals are in place while following healthcare regulations. Verify all Tricare Prime and UHC Medicare Dual Complete HMO plans have active referral on file.

    Numbers & Facts

    LocationSavannah, GA

    Description

    Job Description

    Insurance Verification Specialist - On Site

    Job Title: Insurance Verification Specialist

    Department: Billing

    Immediate Supervisor Title: Billing Supervisor

    General Summary: Review each day’s schedule and verify insurance, updating patient and insurance demographics, and ensuring any necessary referrals are in place while following healthcare regulations.

    Essential Job Responsibilities:

    1. Review current day’s schedule to ensure there are no add ons or any unresolved eligibility issues.
    2. The eligibility goal is to stay five days ahead of the current business day
    3. Update or correct any insurances that run inactive or unverifiable in the system.
    4. Update or correct patient demographics when needed.
    5. Verify all Tricare Prime and UHC Medicare Dual Complete HMO plans have active referral on file.
    6. Complete any internal tasks, emails, and voicemails in a timely manner.
    7. Contact insurance companies, via phone or portal, for network participation and/or patient specific benefits
    8. Utilize our patient communication texting service, Klara, as needed
    9. Maintain HIPAA compliance and confidentiality standards
    10. Ensure office policies and procedures are followed
    11. Maintain good communication with patients, coworkers, and supervisors

    Education: High School Diploma

    Experience: Experience in multi-provider or specialty practice is preferred

    Performance Requirements:

    Knowledge:

    1. Knowledge of medical terminology and insurance processes
    2. Experience with Electronic Health Records (EHR) systems

    Skills:

    1. Written and verbal communication skills.
    2. Customer service excellence
    3. Basic computer skills.
    4. Organizational skills

    Abilities:

    1. Ability to maintain confidentiality
    2. Problem solving abilities

    Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.

    Work Environment: Position is in a well-lit office environment.

    Mental/Physical Requirements: Involves sitting approximately 90 percent of the day, walking or standing the remainder.

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