Insurance Change Specialist

Duties:

• Obtains patient demographic and health insurance information; collects co-pay(s) when appropriate.


• Verifies and records insurance benefits with the ability to understand and provide insurance breakdowns.


• If required by payer(s), obtains prior authorization &/or follows up on authorization daily.


• Able to read through and understand medical documentation effectively


• Resolves Front Collections accounts as well as documenting within computer system appropriately.


• Establishes and maintains effective communication and good working relationships with patients/family, physicians’ offices, and other internal teams for the patient’s benefit.


• Performs other clerical tasks as needed, such as
  
  
  
  1. Answering patient/Insurance calls
  
  
  2. Faxing and Emails
  
  
  
  


• Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Revenue Cycle Manager and Supervisor


• Other responsibilities and projects as assigned.

Requirements:          

• High School Diploma or equivalent.


• Learns and maintains knowledge of current patient database and billing system


• Verifying Insurance for all products


• Understand Insurance benefit breakdown of deductibles and co-ins


• Understand Insurance Medical and Payment Policies


• Knowledge of Explanation of Benefits from insurance companies


• General knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid


• Working knowledge of CPT and ICD-10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.


• Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.


• Utilizes initiative while maintaining set levels of productivity with consistent accuracy.

Experience:

• 2-4 Years in DME or Medical Office experience preferred.


• Minimum of 1 year of insurance verification or authorizations required.

Skills:

• Superior organizational skills.


• Proficient in Microsoft Office, including Outlook, Word, and Excel.


• Attention to detail and accuracy.


• Effective/professional communication skills (written and oral)