Insurance Verification Specialist - Houston, United States - Advanced Diagnostics Healthcare System

Advanced Diagnostics Healthcare System

Verified Company

Houston, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

JOB SUMMARY
The Insurance Verification Specialist is responsible for verifying patient eligibility and insurance plan benefits.

The Insurance Verification Specialist will verify coverage via insurance carrier online portal, contacting carrier directly and document findings on patient Electronic Medical Record (EMR).

DUTIES AND RESPONSIBILITIES

Verify insurance eligibility for upcoming appointments by utilizing online websites or by contacting the carriers directly.
Determines patient copayments and calculates coinsurance and deductibles.
Enters insurance coverage (copayments, deductibles, etc.) accurately into patient Electronic Medical Record (EMR).
Assist front office with verification questions or concerns.
Obtains authorizations for procedures that require approval, as well as following up on pending authorizations.
Communicates insurance coverage with the patient and the staff.
Resolves any coverage issues and update patient Electronic Medical Record (EMR).
Investigates and verifies insurance coverage and eligibility for scheduled services.
Creates and collects patient out of pocket estimates.
Financial clear office visits that may involve minor procedures for specialist services.
Contacts external PCP offices to initiate and secure insurance PCP referral approvals for specialists.

REQUIREMENTS

High school diploma or GED.
Some College, Associate's Degree or higher preferred.
Minimum two years' medical office experience.
Bilingual preferred not required
Intermediate PC Skills, MS Suite
One year of relevant experience in Acute Care setting.
Multi-Specialty insurance verification experience.
Preservice verification experience is preferred.
Epic or similar experience preferred.

EDUCATION

High school diploma or GED.
Some College, Associate's Degree or higher preferred.
Minimum two years' medical office experience.
One year of relevant experience in Acute Care setting.
Multi-Specialty insurance verification experience.
Preservice verification experience is preferred.
Epic or similar experience preferred.

CERTIFICATION, LICENSURE
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N/A

KNOWLEDGE SKILLS & ABILITIES

Knowledge with in and out of network insurances, insurance verification, patient responsibility, and process for prior authorization.
Ability to stay focused in a fastpaced environment, manage time efficiently, and able to multitask.