INSURANCE VERIFICATION SPECIALIST

Leesburg Dermatology & Mohs Surgery

INSURANCE VERIFICATION SPECIALIST

Leesburg, FL
Full Time
Paid
  • Responsibilities

    Benefits:

    401(k)

    Company parties

    Competitive salary

    Dental insurance

    Employee discounts

    Health insurance

    Paid time off

    Profit sharing

    Vision insurance

    Position Summary

    The Insurance Verification Specialist ensures patients are appropriately financially cleared for all appointments. Performs eligibility verification, obtains pre-cert and/or authorizations, clears registration errors and edits pre-bill, and performs other duties as required. Maintains a close working relationship with the clinical department to ensure continual open communication.

    Work Hours/Shift: Must have availability Monday-Friday 8am-4pm

    Travel: None

    Responsibilities

    Proactively contacts insurance companies by phone, fax, online portal, and other resources to obtain and verify insurance eligibility and benefits and determine extent of coverage within established timeframe before scheduled appointments and during or after care for unscheduled patients

    Meet department standard when obtaining pre-authorizations from third-party payers in accordance with payer requirements and within established timeframe before scheduled appointments and during or after care for unscheduled patients.

    Maintain close working relationship with clinical partners and referring offices to resolve issues with obtaining pre-authorizations. Conducts diligent follow-up on missing or incomplete pre-authorizations with third-party payers to minimize authorization related denials through phone calls, emails, faxes, and payer websites, updating documentation as needed

    Minimizes duplication of patient records by using problem-solving skills to verify patient identity through demographic details

    Ensures patient accounts are assigned the appropriate payor plans

    Ensures all financial assessments, eligibility, and benefits are updated and thorough to support post care financial needs. Uses utmost caution that obtained benefits, authorizations, and pre-certifications are correct and as accurate as possible to avoid rejections and/or denials. Maintains a current and thorough knowledge of utilizing online eligibility pre-certification tools made available

    Thoroughly documents all conversations with patients and insurance representatives - including payer decisions, collection attempts, and payment plan arrangements

    Adheres to HIPAA regulations by verifying information to determine caller authorization level receiving information on account.

    Creates accurate estimates to maximize up-front cash collections and adds collections documentation where required

    Calculates patients? co-pays, deductibles, and co-insurance. Provides personalized estimates of patient financial responsibility based on their insurance coverage or eligibility

    Requirements

    Always maintain the highest level of confidentiality to HIPAA standards.

    Must be detail oriented in order to maintain good financial practices, account balances, and financial reporting.

    Good mathematical aptitude

    Ability to multi-task in a stressful deadline-oriented environment.

    Ability to communicate with coworkers, providers and patients in an effective manner.

    Ability to use a computer and enter data in electronic practice management system.

    Good organizing, coordination and office skills

    Customer service orientation and good phone etiquettes

    Must be flexible and understand that job duties may change from time to time and that this individual may be asked to assist in other areas of the office.