Insurance Verification Specialist
Job Title: Insurance Verification Specialist
Reports To: Patient Access Manager
Job Summary: Assists revenue cycle process by verifying patient eligibility prior to date of service based on information on patient’s charts and appointments scheduled.
Essential Job Duties:
The job duties and responsibilities listed below are representative of the knowledge, skill, and/or ability required. Other duties that fall within the broad scope of this classification may be assigned.
- Reviews, verifies, and confirms patient insurance coverage and eligibility prior to time of service.
- Works with internal practice management software and verifies insurance information via external web portals.
- Follows up with patients to obtain any needed or missing insurance or patient information.
- Obtains required information from patients and explains basic insurance benefits, deductibles, and copays.
- Verifies and updates patient demographic information via electronic health record, verbally and/or patient portal.
- Reviews available insurance resources and refers patients as needed for assistance in obtaining insurance.
- Assists CCHCI staff with insurance inquiries as requested.
Minimum Qualifications - Education, Experience, Certificates & Licenses:
- High School Diploma or GED required.
- At least one year customer service telephone-based experience required.
- At least one year computer experience required.
- Any equivalent combination of education and/or relevant experience that provides the necessary skills may be considered.
- Valid Fingerprint Clearance Card required.
- At least one year of experience in a healthcare setting providing office support preferred.
- Experience with medical insurance verification process preferred.
- Knowledge of health plans and community health centers preferred.
Other Required Knowledge, Skills, and Abilities:
- Ability to communicate effectively both verbally and in writing.
- Ability to gather data in an organized fashion from varied sources.
- Ability to perform a variety of assignments and make decisions requiring independent judgment.
- Ability to foresee and address challenges involving one or more variables in routine situations.
- Ability to function effectively in a fast-paced environment and provide excellent customer service via telephone, mail, and in-person.
- Ability to prioritize and plan work activities, use time efficiently, meet deadlines and work independently.
Required Language Skills:
- Ability to comprehend and compose instructions, correspondence, and communications in English in both oral and written format.
- Bilingual in Spanish and English preferred.
- Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
- Ability to continuously remain in a stationary position.
- Ability to occasionally move about inside the workplace to access files, office machinery, etc.
- Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
- Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
- Ability to discern the nature of sounds at a normal spoken volume.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
Work Environment & Conditions:
- Work environment is typical of an administrative office setting with no substantial exposure to adverse environmental conditions.
Job Status: Full Time