Medical Billing - Insurance Verification Specialist

Job Description

Job Description

Medical Biller - Insurance Verification Specialist
Largo, MD

MUST:
The Patient Benefit Representative (Insurance Verification Specialist) must have experience with:
High school diploma or equivalent required
Strong experience verifying insurance coverage and reviewing coverage with patients
Minimum three (3) years patient pre-services coordinator or equivalent required
Proficiency with computer systems and MicroSoft Office (Word and Excel) required
Demonstrate knowledge of CPT coding and HCPS coding application
Must be able to verbally communicate clearly and utilize the appropriate and correct terminology

DUTIES:
Responsible for educating patient on insurance coverage and benefits
Assess patients financial ability; may educate patient on assistance programs
Updates and maintains existing patient new insurance eligibility, coverage, and benefits in system
Prior to a patient receiving treatment; obtains insurance coverage information and demographics; educates patient on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses
Assess patients ability to meet expenses and discusses payment arrangements
Based upon diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form
Completes appropriate reimbursement and liability forms for patient*s review and signature
Forwards appropriate information and forms to billing office
Responsible for obtaining, from Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment
Ensure that patient co-pay amount is correctly entered into system (or conveyed), allowing front desk to collect appropriately
At each patient visit, verifies and updates demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs)
Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient*s records
Maintains updated manuals, logs, forms, and documentation
Performs additional duties as requested

Quadrant is an affirmative action/equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, status as a protected veteran, or status as an individual with a disability. “Healthcare benefits are offered to all eligible employees according to compliance mandated by the Affordable Care Act“.