Why You’ll Love This Job
The Insurance Verification and Authorization Specialist completes verifications of insurance benefits.
The Specialist will work closely with insurance companies, request and monitor verifications and
authorizations and file claims with correct billing codes to accelerate claim processing. The
Specialist must excel at customer service skills in order to interact with patients regarding medical
claims and payments.
Responsibilities
ESSENTIAL FUNCTIONS
• Verification of insurance benefits using payer portals and direct phone calls to insurance companies
• In depth knowledge of insurance plan terminology
• Submission and processing of authorization requests
• Contact insurance company and obtain therapy benefits
• Verify if authorization is required for therapy services
• Obtain authorization for outpatient therapy services if authorization is required
• Provide written insurance verification details to clinic
Monday through Friday, 8:00am-5:00pm. Some night and weekend work may be required.
Skills & Qualifications
QUALIFICATIONS/SKILLS/EDUCATIONAL REQUIREMENTS
- High school diploma or equivalent
- Minimum of 1 year experience in a medical setting performing medical insurance verifications (required)
- Knowledge of medical billing, billing guidelines, insurance claims, authorizations and explanation of benefits
- Proficient in Microsoft, computer skills and electronic medical records.
- Accurate typing and data entry is a must
- Working knowledge of medical terminology, insurance terminology, ICD10 and CPT codes (preferred)
- Accurate, detail-oriented, and able to exercise reasonable initiative in completing all assignments in a timely manner
- Ability to organize and prioritize workload as well as ability to meet deadlines on a constant basis
- Excellent verbal and interpersonal skills in working with residents, patients, insurance carriers, Shell Point co-workers, and management
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