Insurance Specialist
External
Full-timeRemote1w ago
ComplianceDocumentation
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Requirements
- Required:
- Education: H.S. Diploma or GED
- Experience: 0-1 years of experience in insurance verification, medical billing, or healthcare revenue cycle
- Knowledge, Skills and Abilities:
- Strong knowledge of insurance plans, authorization requirements, and medical necessity guidelines.
- Proficiency in Microsoft Office Suite and healthcare information systems (e.g., EMR, eligibility portals).
- Excellent attention to detail and organizational skills.
- Strong communication and interpersonal skills to interact effectively with patients and healthcare professionals.
- Ability to work in a fast-paced environment and manage multiple priorities effectively.
- We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible.
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Benefits
PTOPaid holidaysEmployee Incentive Program (ICP)Group Medical, Dental, & VisionEducational Assistance401(k) PlanSick TimeLife Insurance/Accidental Death and DismembermentLong-Term and Short Term DisabilityMedical and Child Care Flexible Spending AccountsEmployee Assistance Program (EAP)Job SummaryEssential Functions:Verifies insurance eligibility and benefits for scheduled and unscheduled services to ensure coverage and compliance with payor requirements.Calculates and communicates the patient's estimated financial responsibility for scheduled services.Identifies and ensures authorization and referral requirements are met in accordance with payor guidelines.Validates and documents all authorizations and referrals according to established policies.Reviews and determines the medical necessity of scheduled services based on payor criteria.Accurately documents and maintains all required records and communications in compliance with organizational standards.Communicates effectively and professionally with patients, physicians, and medical office staff to resolve inquiries and ensure adherence to payor requirements.Educates patients on insurance coverage, benefits, and financial responsibility, ensuring clear understanding.Processes and indexes incoming orders promptly and ensures compliance with documentation standards.Provides timely notification of admission or observation status per payor guidelines for inpatient and observation services.Performs other duties as assigned.Complies with all policies and standards.This is a remote position.
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