Insurance Verification Specialist (REMOTE)
Job description
Candidates must live within one of the following states to be eligible for this position; Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, Wyoming
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Verifies detailed insurance benefits, medical necessity, and authorization/referral guidelines, consistently prioritizing and following the established verification processes.
- Communicates outstanding documentation requests, required account follow-up, and payor issues to the appropriate facility contacts.
- Responsible for maintaining performance standards that ensure the department is operating at peak proficiency and that established goals are consistently being met while maintaining effective communication with patients, physicians, medical office staff, and both internal and external co-workers.
- Calculates the estimated patient financial responsibility via the estimation tool.
- Notates all actions performed in the applicable host system(s) immediately.
- Performs all other duties, as assigned or requested, while adhering to strict deadlines.
QUALIFICATIONS
REQUIRED EDUCATION
- High School Diploma or Equivalent
REQUIRED EXPERIENCE
- 1+ years of medical office, medical insurance company, or healthcare facility experience
- Knowledge of CPT, ICD-10, and medical terminology
LICENSE/REGISTRATION/CERTIFICATION
- Certified Professional Coder (CPC) (PREFERRED)
KNOWLEDGE, SKILLS AND ABILITIES
- Ability to define problems, collect data, establish facts and draw valid conclusions. Interprets an extensive variety of payer requirements.
- To perform this job successfully, an individual should have knowledge of host systems, ancillary applications, and payor web applications.
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