INSURANCE VERIFICATION SPECIALIST

Salary Range:  $19.0800 - $29.3200 /hour. Actual compensation may vary based on geographic location, work experience, skill level, and education.

Primary Duties and Responsibilities

The Insurance Verification Specialist verifies insurance and benefit coverage for services in assigned department(s). This role works directly with patients, insurance companies, and clinical departments to verify insurance coverage, obtain proper authorizations, and ensure timely reimbursement of services. Reviews physician orders for medical necessity and accuracy and provides clinical documentation to support proper authorization. Accurately and timely codes insurance in the billing system. Provides patient education of service of benefits, status of pending or denied authorizations and gets assistance in resolving. Determines copayment and deductible amounts, maintains charge entry and reconciles daily charges. Accurately enters insurance benefit and authorization information into patient accounts. Seeks assistance as needed to maintain service levels. May arrange for peer-to-peer evaluations between physician offices and insurance companies as requested. Performs other duties as assigned.

Education and Experience

High school diploma or equivalent required. Two to three years’ experience in patient access or related healthcare experience required. Intermediate knowledge of Windows computers and data entry required. Experience with billing, insurance verification, coding, authorization guidelines, ICD 10 and CPT-4 coding, and/or medical terminology preferred. Degree and/or certificate in related field preferred.

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.