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Job description
Insurance Verification SpecialistUnder the direction of the Patient Access/Central Scheduling Manager, the Insurance Verification Specialist is responsible and accountable for the daily oversight of all Insurance and Eligibility verification for Outpatient procedures as scheduled and/or add on procedures throughout the various hospital departments. Responsible for contacting provider(s) offices regarding the necessity of prior authorizations to ensure appropriate reimbursement. Responsible for contacting the appropriate provider(s) as necessary when Insurance and Eligibility changes in coverage are identified. Utilizes a variety of communication methods to effectively communicate inter-departmentally, with provider(s) offices as well as with Insurance companies. Responsible for the identification of any Outpatient tests/procedures completed that may require retro-authorization in order to obtain reimbursement. Works with multiple hospital departments in the creation of financial accounts as necessary prior to the treatment of the patient. Works continually with schedulers to ensure all authorizations required are in place prior to the scheduling of the test/procedure. Functions as subject matter expert to both internal and external customers.JOB REQUIREMENTSEducation: High School Diploma or equivalent.Experience: 12 to 18 months related experience and/or training in the healthcare and/or office/clerical and customer service fields.Other: Preferred applicant will have a working knowledge of medical terminology, ICD 10, CPT and HCPCS coding basics. Adaptability to multiple systems is essential in-depth knowledge of federal and state employment laws. Working knowledge of Microsoft Office Suite, databases and general office equipment. Must be extremely detail oriented, organized and conscientious to ensure high quality work. Excellent time-management and follow-up skills to ensure work deadlines are met. Outstanding communication, presentation and interpersonal skills. Must be a positively contributing team player and possess willingness to be cross-trained in other functional areas. Ability to maintain a high degree of confidentiality with regard to employment data, HIPAA, and departmental operations.
Worksite address
mountain home, AR, 72653, US
Who can apply
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