Medical Insurance Verification Specialist - Remote, United States - pMD

Description

We hold ourselves to exceptionally high standards in order to provide unparalleled service to healthcare professionals, their staff and patients. We strive to end each workday knowing that we've made someone's life better.

Our team is comprised of courageous and caring healthcare warriors. We're here to solve the impossible problems, such as reducing medical errors, saving patient lives, and empowering physicians to stay financially independent. We care deeply about making a big impact and we are relentless.

Inspired to grow the company and our careers, we remain committed to daily discipline, self improvement, and a ceaseless search for solutions.

We equally value our work and our life apart from work. We're compelled to work with urgency, decisiveness, and efficiency in everything we do. This affords us freedom and time for things that matter most.

Leaders at pMD are developed through our mentorship program. Investing in the success of each individual strengthens our team and builds loyalty. We believe in leading by example. Everything one does ripples outward. Therefore, we need each individual at pMD to embody our leadership principles to thrive as an enduring great company.

(Contract) Medical Insurance Verification Specialist

The (Contract) Medical Insurance Verification role at pMD is responsible for performing detailed insurance benefit verifications of all patients' prior to claim submission to the carrier. This is an important role in identifying active coverage under the correct policy, while effectively communicating with third-party payers.

Responsibilities include:

• verifying a patient has active coverage with the insured carrier following an inpatient encounter using an electronic eligibility solution
• if the carrier returns ineligible, identify the correct coverage by leveraging the integrated eligibility tool, HL7 interface message, or attached facesheet. If a patient is identified as self-pay, update the financial class
• when coverage returns that an advantage plan has been detected, identify the correct carrier and policy number to be billed using an eligibility solution. Update insurance information in the patient's record based on the eligibility response
• identify the correct policy to be billed when a patient is identified as being enrolled in hospice by referencing the eligibility response
• for carriers that do not offer an electronic eligibility response, contact the carrier by phone to complete the verification. A carrier contact list will be provided to facilitate outreach

Requirements include:

• proficient in health insurance verification and benefits
• knowledge of CPT codes and basic medical terminology (preferred)
• must be able to work independently in a fast-paced environment
• exceptional attention to detail
• w9 required - must currently work as a sole proprietor or have or be willing to register a business per independent contractor guidelines
• reside in the U.S.

We are only accepting applications through our online job portal, Lever. We aren't able to consider and respond to other types of applications, including those sent via email to pMD support, at this time. Please direct application status questions to

Candidates must be authorized to work in the U.S. as a precondition of employment.