RCM/OPH Insurance Verification Specialist

Job Title: Insurance Verification Specialist

Must reside in the following states: AL, AZ, FL, GA, IL, IN, KS, KY, MI, MN, MO, NC, NJ, OH, OK, PA, TX, VA

Job Summary

As a member of the Revenue Cycle Management Team, the Insurance Verification Specialist is responsible for all aspects of insurance verification. This position will complete pre-registration processes and communicate pertinent appointment information to Front Desk, Patient Intake Specialists, the Prior Authorization Department, or the Clinic, as needed

Duties and Responsibilities

• Obtain information about patient insurance coverage, benefits and eligibility

• Maintain strict confidentiality in accordance with HIPAA regulations and Company/Clinic requirements

• Provide support to all departments and patients regarding insurance questions related to eligibility and benefits.

• Answer incoming and transferred calls from patients regarding the pre-registration process.

• Prepare patient appointments for a smooth and efficient check-in process on the day of the appointment.

• Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.

• Performs other duties that may be necessary or in the best interest of the organization.

Education, Licensure & Certification Requirements

High School Diploma or GED

Experience Requirements

At least one (1) year medical office experience required; Medical office/front desk experience preferred

Knowledge, Skills and Abilities Requirements

• Comprehensive understanding of insurance verification, Ability to enter data into various electronic systems while maintaining the integrity and accuracy of the data

• Ability to perform essential job function with high degree of independence, flexibility, and creative problem-solving techniques

• Ability to function effectively under stress of conflicting demands on time and attention, while successfully meeting deadlines

• Ability to maintain control of a call de-escalating issues and instilling confidence that a resolution will be found

• Logical and Critical thinking skills

• Excellent organization, time management, and prioritization skills

• Professional in appearance and actions

• Enjoys learning new technologies and systems

• Detail oriented, professional attitude, reliable

• Exhibits a positive attitude and is flexible in accepting work assignments and priorities

• Meets attendance and tardiness expectations

• Management and organizational skills to support the leadership of this function

• Interpersonal skills to support customer service, functional, and teammate support need

•  Able to communicate effectively in English, both verbally and in writing with sufficient grammar and spelling skills to avoid mistakes or misinterpretations

• Basic to intermediate computer operation

•  Proficiency with Microsoft Excel, Word, and Outlook

• Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines

Location/Work Environment:

For on-site team members, work takes place in a normal office/clinical environment. Travel to other locations may be necessary to fulfill the essential duties and responsibilities of the job. Thus, those needing to travel for work must have access to dependable transportation, and their driving record must meet company liability carrier standards.
For remote team members, HIPAA compliant home office environment. Ability to work in a remote environment while performing required duties and remaining patient focused. Able to work varying shifts including early mornings/evenings to attend meetings and cross training or support other initiatives.