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  • Coraopolis, PA 15108

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Insurance Verification Associate

Apex Systems • Coraopolis, PA

Posted 14 days ago

Job Snapshot

Full-Time
Degree - High School
Other Great Industries
Insurance

Job Competition

75+

Applicants

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Job Description

Insurance Verification Associate  

Insurance Processing Division

EDUCATION AND TRAINING REQUIREMENTS:

High School diploma required. 

College degree preferred or equivalent experience insurance verification experience.   

MAJOR GOALS AND RESPONSIBILITIES:

Process and complete orders with zero billing errors as promptly as possible. Accurate, timely order entry into the computer billing system.  Verifying insurance and obtaining authorization or medical documentation required.  Maintaining computer Master Files to eliminate billing errors. 

ESSENTIAL ACTIVITIES:

  1. Enter customer demographics and orders into the billing system including all information necessary for billing.
  2. Collect Insurance benefit information from an Insurance representative or web portal and use this information to make a determination of a patient’s insurance coverage for MPCS services.  Validate codes and fees to assure there is coverage under the patients policy
  3. Obtain Insurance authorizations when required by the Insurance..
  4. Contact patients to explain benefits and financial responsibility for MPCS services and assist them with questions regarding their insurance coverage.
  5. Obtain medical documentation from physician’s offices or other healthcare professionals to support the necessity for supplies.
  6. Contact referral sources and patients to discuss any problems or delays encountered during insurance verification.
  7. Assist patients and referrals in finding an alternative provider with MPCS is not contracted with the insurance.
  8. Utilize the Workflow system to create and route required forms to the patients file.
  9. Prioritize urgent or emergency orders.
  10. Closely monitor the billing system Master Files and make necessary updates.  Add new doctors and referrals to the billing system
  11. Follow all HIPAA, Accreditation and Insurance guidelines during order processing
  12. Validate and Log PO/RX/CMNs and PARs as needed.

PRIMARY PEOPLE CONTACTS:

Customers, Physicians and their staff, Referrals, Insurance Company Representatives, Family members and all MPCS staff.

REPORTS TO: 

Manager of Insurance Processing

BEHAVIORAL TRAITS, ATTITUDES AND SKILLS REQUIRED:

Highly assertive, independent decision-maker with excellent communication skills.  Detail and results oriented with superior organizational skills. Computer experience, typing skills required.

TOUGHEST PARTS OF THIS JOB:

Managing multiple tasks and multiple personalities. Understanding all systems and their effect on billing.  Keeping current and communication with other team members on changing insurance requirements.

ACTIVITY LEVEL: Minimal (High Volume Typing/Desk Work/driving/Patient Care) with reasonable accommodation.

INDICATORS:

Hold Revenue Report, Open Order Report, Accounts Receivable Reports/Claim Analysis Report, Customer Satisfaction Surveys, Monthly individual scorecards, Mid and year-end reviews

EEO Employer

Apex is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at 844-463-6178

Job ID: 863030
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