Insurance Verifier

Job Details: Job Location: CMMC South Campus - Floresville, TX, Position Type: Full-Time/Part-Time, Education Level: High School, Salary Range: Undisclosed, Travel Percentage: None, Job Shift: Day, Job Category: General Business, Summary Works directly with clinics to identify and secure payer referral requirements for maximum reimbursement

Essential Duties and Responsibilities include the following. Other duties may be assigned.

Work requests from a queue or email communication from clinic staff or other source
Confirm validity of any referrals already on file
Submit request for needed referrals to appropriate authority or PCP
Follow up to secure authorization prior to patient appointment to ensure reimbursement
Provide requested clinical information to PCP to support referral
Advise clinic staff of any anticipated delays for authorization
Secure referrals and enter them in the patient’s electronic record

Education and/or Experience

Strong, working knowledge of insurance payers to include government, commercial and managed care products
Ability to establish a good rapport with outside providers and third party payers
Resourceful, steadfast attitude to make sure that patient needs are met timely
Comfortable with navigating through the payer websites to secure appropriate benefits and authorization requirements
Excellent verbal and oral communication skills
Excellent customer service skills are expected with internal and external customers

Other Qualifications:

Must be able to multitask and demonstrate excellent organizational skills
Understanding of insurance contracts and networks essential
Extensive coding and medical terminology preferred
Computer literate, knowledge of, or ability to learn multiple clinic/hospital software required.

Qualifications: Education and/or Experience

Strong, working knowledge of insurance payers to include government, commercial and managed care products
Ability to establish a good rapport with outside providers and third party payers
Resourceful, steadfast attitude to make sure that patient needs are met timely
Comfortable with navigating through the payer websites to secure appropriate benefits and authorization requirements
Excellent verbal and oral communication skills
Excellent customer service skills are expected with internal and external customers

Other Qualifications:

Must be able to multitask and demonstrate excellent organizational skills
Understanding of insurance contracts and networks essential
Extensive coding and medical terminology preferred
Computer literate, knowledge of, or ability to learn multiple clinic/hospital software required.