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Insurance Verification Specialist

companyExtremity Care
locationConshohocken, PA 19428, USA
PublishedPublished: 6/14/2022
Full Time

Job Description

Salary: $22+

**This is an hybrid position in our Conshohocken office**

Purpose:

Reimbursement Specialists are primarily responsible for working with insurance companies and medical billing staff to manage the billing/reimbursement process. Specialize in tasks related to ensuring that the company is paid appropriately for their services. 

Duties & Responsibilities:

  • Verify eligibility and benefits using electronic database/clearinghouse and via telephone.
  • Review documentation for coding compliance and medical necessity.
  • Manages and coordinates all Insurance benefits to ensure patient responsibility.
  • Prepare insurance verification response to providers.
  • Telephone communication with payers to verify eligibility, benefits, prior authorization.
  • Experience with payer websites, electronic clearinghouses, Availity
  • Medical coding knowledge
  • Review records, coding, and billing practices to ensure compliance.
  • Initiate prior authorizations.
  • Communicate with providers and internal staff regarding insurance verifications and patient benefits.
  • Follow up on prior authorizations.
  • Assist with claim follow up, billing onboarding, and calls to providers to educate offices on billing for the products.

Skills & Abilities:

  • Ability to interpret medical benefits.
  • Must have attentive to detail, accuracy and must possess organizational skills.
  • Excellent communication and documentation skills required.
  • Ability to discuss patient benefits with providers, medical staff, and sales personnel.
  • Solid understanding of Medicare LCDs and commercial medical policies.
  • Knowledge of CPT, HCPCS, and ICD10 coding and medical terminology.
  • Proficient in Word, Excel, computer entry (required)
  • Medical Billing or Coding Certification (preferred)
  • Experience in medical billing, precertification, and insurance verification.

Education & Experience:

  • High School Diploma or Equivalent (required)
  • 2-3 years previous medical billing experience (required)

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