Insurance Verification Specialist

Insurance Verification Specialist Overview

• The Insurance Verification Specialist role involves ensuring accurate insurance verification and billing processes for patient appointments and claims.
• Work in a fast-paced environment requiring strong organizational and detail-oriented skills.
• Collaborate with healthcare professionals to maintain efficient insurance and billing workflows.
• Gain experience in ICD-10 and CPT code usage for claim processing and charge entry.
• Contribute to patient financial planning by evaluating financial statuses and establishing payment plans.
• Ensure compliance with insurance policies and procedures through verification and follow-ups.
• Perform electronic billing tasks and manage ERA payment postings effectively.
• Develop skills in handling patient inquiries and resolving billing-related issues.

Insurance Verification Specialist Key Responsibilities & Duties

• Verify insurance benefits for scheduled appointments via phone or internet.
• Notify patients of benefits and estimated financial responsibilities.
• Obtain referrals as required for specific patient visits.
• Scrub claims to ensure accurate ICD-10 and CPT code charges.
• Follow up with insurance companies on outstanding or denied claims.
• Submit corrected claims, reconsideration requests, and appeals as needed.
• Post ERA payments and manage electronic billing processes.
• Handle patient calls, resolve billing inquiries, and establish budget payment plans.
• Perform additional duties as assigned to support departmental operations.

Insurance Verification Specialist Job Requirements

• High School Diploma or GED is required.
• 1-2 years of relevant experience in insurance verification or billing preferred.
• Knowledge of ICD-10 and CPT codes is essential.
• Strong organizational skills and attention to detail are necessary.
• Ability to work independently and manage multiple tasks effectively.
• Proficiency in electronic billing and ERA payment posting is advantageous.
• Excellent communication skills for handling patient inquiries and insurance follow-ups.
• Availability to work full-time, Monday through Friday, 8am to 5pm EST.