Insurance Eligibility Verification Specialist

Job Description:

• Responsible for verifying patients’ insurances, as well as their covered benefits and for confirming pre-authorizations for services.
• Works well as part of a team and effectively communicates.
• Assists practice staff with eligibility, as necessary.
• Serves as a liaison between the RCM department and the various PTC facilities.
• Handle high volume of inbound/outbound calls for patients that need to be screened financially and medically for financial assistance.
• Complete verification of benefits for multiple clients within the appropriate timelines.
• Maintains high quality customer service standards in compliance with federal and state regulations and guidelines.
• Provide periodic processing status updates.
• Assist in researching reimbursement issues relevant to benefits/eligibility issues.
• Assist in training of new team members.
• Enter and update patient demographics into the billing system as needed.
• Complete KPI reports as requested by management and the clients.
• Update and manage the VOB tracker for multiple clients.
• Understand federal and state requirements regarding client confidentiality and the principles of maintaining protected health information (PHI).
• Work effectively and maintain expected productivity.
• Other tasks or duties as assigned.

Requirements:

• Associate’s degree preferred or experience in lieu of degree.
• 1-2 years'+ experience in front-end medical office operations.
• Prior experience working in a role with a high volume of either inbound or outbound calls.
• Experience and knowledge of federal or state government agencies including Social Security, Medicaid and/or Commercial coverages, familiar with the healthcare revenue cycle touching patient accounts.
• Experience working in a role that requires prioritization of multiple critical priorities while ensuring quality and achievements of performance metrics.
• Experience with customer interactions which requires live, accurate documentation of the encounter.
• Previous experience collecting patient payments or copays.

Benefits:

• 18 days PTO (Paid Time Off) + 8 paid holidays
• 401k with company match
• Company sponsored ongoing training and certification opportunities.
• Full comprehensive benefits package including medical, dental, vision, short term disability, long term disability and accident insurance.
• Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP)
• Discounted tuition and scholarships through Capella University

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