Insurance Verification Specialist
Core
Reintegrate patient accounts into the reimbursement process by verifying eligibility, securing prior authorizations, and resolving claim errors to ensure accurate payment.
Role type
Healthcare revenue cycle specialist (eligibility and benefit verification)
Builds
Clean patient accounts and resolved claims for Cardiology Healthcare teams
Domain
Healthcare / Medical Billing / Insurance Verification
Required skills
Eligibility and benefit verification, Claims submission, Medical record review, HIPAA compliance, Payer policy knowledge, Patient contact management, Revenue report analysis, Microsoft Office proficiency
Preferred skills
Cardiology experience, Third-party payer experience, Associate's degree or higher
Responsibilities
Develop strategies to reintegrate patient accounts into the reimbursement process, Perform detailed research on patient accounts within the 'Error processing' process, Apply investigational tools to find patient contact information, Ensure accuracy of patient demographics and benefit information, Process claims promptly and resolve adjudication issues, Identify payer trends and implement specific strategies, Review revenue reports to ensure reimbursement procedures are followed, Contact patients and caregivers to acquire current information, Foster relationships with sales and healthcare teams, Offer customer service on payer policies and coverage criteria
Seniority
Mid-level, hands-on IC