Insurance Verification Specialist

Overview

• Provide critical insurance verification services to ensure seamless patient appointment scheduling and accurate financial responsibility communication.
• Handle patient inquiries regarding billing, payment plans, and insurance coverage with professionalism and efficiency.
• Perform charge entry tasks, ensuring accuracy in ICD-10 and CPT coding for electronic billing submissions.
• Collaborate with team members and healthcare providers to streamline insurance verification processes.
• Maintain organized and detailed records of insurance claims, payments, and patient interactions.
• Work independently in a fast-paced environment, ensuring all tasks are completed with precision and timeliness.
• Support the department’s objectives by performing additional duties as assigned.

Key Responsibilities & Duties

• Verify insurance benefits for scheduled appointments, ensuring compliance with policies and notifying patients of coverage details.
• Obtain necessary referrals and authorizations for specific appointment types to facilitate smooth patient care.
• Address patient billing inquiries and resolve issues promptly, providing exceptional customer service.
• Scrub claims for accuracy in ICD-10 and CPT coding, preparing them for electronic submission.
• Follow up on outstanding or denied claims, submitting corrections and appeals as required.
• Post ERA payments accurately and maintain detailed transaction records for auditing purposes.
• Collaborate with insurance companies to resolve claim discrepancies and ensure timely reimbursements.

Job Requirements

• High school diploma or GED required; 1-2 years of relevant experience preferred.
• Proficiency in insurance terminology, ICD-10, and CPT codes essential for success.
• Strong organizational skills and ability to work independently in a fast-paced environment.
• Experience with electronic billing systems and ERA payment posting is highly desirable.
• Excellent communication skills for interacting with patients and insurance companies effectively.
• Detail-oriented approach to claim scrubbing and maintaining accurate records.
• Ability to efficiently verify insurance benefits and obtain necessary referrals.