Insurance Verification Specialist

Overview

• Provide insurance verification services for patient appointments, ensuring accurate benefit determination and financial responsibility communication.
• Handle patient inquiries regarding billing, financial status, and payment plans with professionalism and efficiency.
• Perform charge entry tasks, scrubbing claims for ICD-10 and CPT code accuracy before electronic billing submission.
• Follow up on outstanding or denied claims, submitting corrections, reconsiderations, and appeals as necessary.
• Post ERA payments accurately and maintain detailed records of transactions.
• Work independently while maintaining organization and attention to detail in all tasks.
• Collaborate with team members and physicians to ensure seamless insurance verification processes.
• Perform additional duties as assigned to support the department's objectives.

Key Responsibilities & Duties

• Verify insurance benefits via phone or internet for scheduled appointments, notifying patients of coverage details and financial responsibilities.
• Obtain referrals as required for specific appointment types, ensuring compliance with insurance policies.
• Answer incoming patient calls, addressing billing inquiries and resolving routine issues promptly.
• Evaluate patient financial status to establish budget payment plans when necessary.
• Scrub claims for accurate ICD-10 and CPT code charges, preparing them for electronic billing submission.
• Follow up with insurance companies on outstanding or denied claims, submitting corrections and appeals as needed.
• Post ERA payments and maintain detailed transaction records for auditing purposes.
• Maintain organization and detail orientation in all aspects of the role.

Job Requirements

• High school diploma or GED required, with 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 preferred.
• Excellent communication skills for handling patient inquiries and insurance company interactions.
• Detail-oriented approach to scrubbing claims and maintaining accurate records.
• Ability to obtain referrals and verify insurance benefits efficiently.