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Company Contact Info

  • Nashville, TN
  • Medix

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Health Insurance Verification Representative

Medix • Nashville, TN

Posted 24 days ago

Job Snapshot

Contract to Hire
$14.00 - $16.00 /Hour
Insurance
Health Care, Insurance
75+

Applicants

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Job Description

At Medix, we are dedicated to creating opportunities for talent through our Healthcare, Scientific and Information Technology divisions. Our dedicated recruiters offer a personalized service to make sure we truly understand your employment needs. We are currently seeking a (omitted but job title with relevant experience).

Partner with Medix, and you will experience the multiple benefits our company has to offer. We will hold a personal consultation with you to understand your skills and aspirations! Our placement services provide flexibility to accommodate your schedule and needs, offering contract, contract-to-hire and direct hire positions.


Health Insurance Verification Representative - Prior Authorization - Administrative Clerical - Healthcare


Job Responsibilities

As an Insurance Verification Representative, you will be responsible for obtaining required documentation in compliance with governmental and commercial payer requirements in order to ensure the reimbursement of services provided to patients. You will review requests from doctors and pharmacists to determine whether prior authorization of medication coverage can be given; this will be accomplished by screening and reviewing requests based on benefit plan design, client specifics, and clinical criteria.

Other responsibilities of the Prior Authorization role include:

  • Verifying insurance benefits for commercial and governmental payers
  • Obtaining insurance authorizations in a timely manner for equipment/services provided
  • Handling inbound telephone and written inquiries from pharmacists and doctors
  • Screening and reviewing requests based on benefit plan design, client specifics, and clinical criteria
  • Providing information to clients, participants, pharmacists, and doctors regarding participants pharmacy benefits and drug coverage
  • Providing accurate procedures for medication exceptions
  • Facilitating resolution of drug coverage issues and proactively resolving issues
  • Maintaining accurate and complete documentation of all inquiries for continuous improvement


Health Insurance Verification Representative - Prior Authorization - Administrative Clerical - Healthcare


RequirementsAs an Insurance Verification Representative, you must be able to work independently, prioritize tasks, and stay organized in a high volume, inbound call center setting. You must have excellent communication and organizational skills with the ability to multitask and collaborate in a team-oriented environment.

Other requirements of the Prior Authorization role include:

  • High school diploma or equivalent certification
  • Previous administrative clerical or related experience
  • Previous Prior Authorization Representative experience, a plus
  • Knowledge of medical terminology
  • Computer skills and experience with Microsoft Office Applications


Health Insurance Verification Representative - Prior Authorization - Administrative Clerical - Healthcare


Benefits

In order to be eligible for health benefits, you must be employed for 30 days and must average 30 hours per week for four consecutive weeks.

As a contract employee with Medix, you can choose to enroll in our Benefits Program during your eligibility period and enjoy:

  • 401(k) Retirement Plan
  • Medical, dental and vision plan with American Worker
  • Prescription Programs
  • Term Life Insurance Plan


Health Insurance Verification Representative - Prior Authorization - Administrative Clerical - Healthcare

Medix - Positively Impacting Lives


Featured on such prestigious lists as Inc. Magazine's "Inc. 5000" list of the nation's fastest growing private companies, as well as Inavero's "Best of Staffing" Client list.

"The Medix team's support and encouragement provided me with the confidence I required while pursuing a position in which I continue to excel and grow, both professionally and personally." -Sam, Medix Talent.

Join our network of talented professionals!

Apply today!

Job Requirements

Candidates in this position will be taking inbound and outbound calls and making calls to patients and discussing their insurance coverage the patient would have on their health plans.

Candidates will be reviewing and verifying the patient's insurance plans and Coordination of Benefits.

Candidates would be discussing Co-Pays would be needed, or if there was a debatable to be given so forth.

Candidates would direct patient calls to the correct department if a payment needs to be made.

Candidates will be looking at EOB's and would be setting up the next steps and produces for the patient.

Candidates would be reviewing and working with multiple insurance payers such as: Medicare, Medicaid, and Commercial such as: Blue Cross Blue Shield, Cigna Health Spring, United Healthcare, and etc
Job ID: 69642
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