Insurance Verification Specialist

RCM INSURANCE VERIFICATION SPECIALIST performs clerical functions for patient billing, including verification of insurance information and resolution of problems to ensure a clean billing process. Follows up on accounts that require further evaluation. Works with others in a team environment. 

Essential Functions:

• Maintains patient demographic information and verifies, enters or updates insurance information for new patients and existing patients to include copays and deductibles 


• Verify insurance eligibility for upcoming appointments by utilizing EMR, online websites or by contacting the carriers directly.   


• Explain financial responsibilities to patients.


• Coordinate with staff and management regarding scheduling errors.  Update the error spreadsheet daily. 


• Enter insurance effective dates and/or authorization details.


• Participates in development of organization procedures and update of forms and manuals. 


• Answers questions from patients, clerical staff and insurance companies.


• Works in conjunction with the reception to ensure clean billing. 


• Performs miscellaneous job-related duties as assigned. 


• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations. 


• Assists in development and communication of SOP for key areas to improve accuracy and understanding of processes. 

Process:

• Check assigned locations daily and confirm eligibility, copay, and outstanding balance for every scheduled patient.  


• Enter and update carrier details in the insurance section of the patient account to include plan name, effective dates, co-pays and deductibles.


• Flag and address potential errors.  All errors should be logged onto the Eligibility Error Spreadsheet 


• Add copay and outstanding collection notes in the appointment details for the PSR to see and address during the check in process. 


• If further action is needed, due to portal downtime or insurance errors, enter notes into the appointment details for the PSR to see. 


• Maintain regular verification management at least two days ahead of schedule 


• Attempt to collect outstanding balances and/or work with RCM management to assist with questions 

Qualifications:

• Minimum of 1 year working in a medical office.


• Medical Billing experience preferred.


• Must be comfortable asking for payment.


• Must have outstanding phone etiquette and attention to detail. 

Benefits:

• Medical, Dental, Vision Coverage


• Life Insurance


• Paid Time Off


• Long Term Disability


• 401K Plan

Job Type: Full-time