Insurance Verification Specialist

Job Description:

Insurance Verification Specialist

Responsible for timely updating and adding current payer plan to the patient’s chart utilizing all available electronic tools, including making outgoing telephone calls to both patients and payers’ plans.

What You’ll Be Doing

• Via electronic tools, update all requisite payer plan information, including subscriber and patient ID #, within the Urology of Indiana practice management system prior to the patient appointment.

• Daily, run and work the Eligibility queue report per assigned locations.

• Monthly, run a patient aging report and review accounts to identify, add, and/or update any missing or incorrect insurance.

• If previous claims were filed with an invalid payer plan, add the correct payer; change the status and owner on the claim, and rebill all of the claims.

• Apply patient alert on the chart “Front desk- please task new insurance card”.

• When changing insurance in iSALUS, if the appointment type is at a hospital (inpatient/outpatient), send via email to the surgery scheduler or precert team member to advise them of the change.

• In the event eligibility cannot be confirmed via available tools, contact (via telephone) the patient.

• If no response from patient within three business days, send the patient an insurance information letter and apply an alert to the patient’s chart (prompts front office to task a new insurance card.) Expire the alert in 7 days.

• If the Medicare plan is on the patient chart, verify or add the new MBI number.

• Handles inbound calls from locations, patients, etc., with general insurance questions.

• Back up to charge entry and payment posters.

• Responsible for mail distribution, faxes, copies, scanning, and the E-doc process.

• Provide benefits estimates for patients’ procedures.

• Other duties as assigned

What We Expect from You

• Knowledge of medical terminology

• Understanding how to interpret commercial payers, Medicaid, and Medicare’s benefits and eligibility information on all of the respective payers’ websites.

• Good organization and strong follow-through skills.

• Ability to respond to questions in a tactful and professional manner.

• Detail-oriented- must pay attention to details.

• Ability to maintain confidentiality.

Education and/or Experience

High school diploma or three to five years related experience and/or training in the collection of medical accounts; or equivalent combination of education and experience.

Knowledge of insurance regulations and procedures. Experience with CPT-4 and ICD-10 is preferred.

Language Skills

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine correspondence. Ability to speak effectively before individuals or groups of people.

Mathematical Skills

Ability to calculate basic figures and amounts. Ability to apply concepts of basic algebra and geometry.

Reasoning Ability

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Computer Skills

To perform this job successfully, an individual should have knowledge of basic computer software.

Other Skills and Abilities

Strong written and oral communication skills

Demonstrate a positive, cooperative, and professional attitude towards co-workers and the public.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is frequently required to stand, walk, sit, use hands to finger, handle, or feel, reach with hands and arms, stoop, kneel, crouch, or crawl, and talk or hear. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.

Work Environment

This job operates in a remote work environment. This role routinely uses standard office equipment such as computers and phones.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Position Type/Expected Hours of Work

This is a full-time position. Days and hours of work are Monday through Friday, approximately 8 hours per workday. Occasional evening and weekend work may be required as job duties demand.

What We are Offer You

At U.S. Urology Partners, we are guided by four core values. Every associate living the core values makes our company an amazing place to work. Here “Every Family Matters”

Compassion

Make Someone’s Day

Collaboration

Achieve Possibilities Together

Respect

Treat people with dignity

Accountability

Do the right thing

Beyond competitive compensation, our well-rounded benefits package includes a range of comprehensive medical, dental and vision plans, HSA / FSA, 401(k) matching, an Employee Assistance Program (EAP) and more.