Revenue Cycle Specialist III- Insurance Verification Specialist

Job Summary: 

The Insurance Verification Specialist will obtain detailed verification of benefits for in-office appointments. As a key team member, they will ensure patient billing information is accurate and any referrals are obtained with the main objective of minimizing controllable denials and maximizing the clean claim rate.

Job Duties & Responsibilities: 

• Responsible for verifying all in-house patient insurance benefits on the internet or by telephone on a daily basis, to include in office procedures and testing. 

• Recheck schedules daily for any add-ons.

• Strong knowledge of payers and payer websites.

• Document and upkeep benefit information in patient account to ensure appropriate collection.

• Responsible for adding alerts of any missing information and past due amounts in the billing system with date reviewed. 

• Ensures billing system has the correct patient insurance benefits including but not limited to member ID numbers and group numbers. 

• Notifies schedulers of any referrals needed, missing or inactive insurance and adding comments in the system.

• Monitor and maintain internal eligibility checks performed by practice management system. 

• Responsible for reporting any delays in completion of daily duties to supervisor in a timely manner.

• Resource for patient benefit questions. 

• Maintain work productivity and quality standards, policies and procedures and escalate compliance issues to supervisor. Productivity standards can fluctuate based on volume of work. 

• Perform a variety of administrative duties including but not limited to: answering phones, faxing, filing of confidential documents in addition to basic Internet and e-mail utilization. 

• Provide excellent customer service to patients and internal staff.  

• Function as a contributing team member while meeting deadlines and productivity standards.

• Other duties as assigned by the management team.

MINIMAL REQUIREMENTS:

• High School Diploma or equivalent
• Minimum 3 years recent experience 
• Understanding of medical claims and coding
• Medical billing and collections in a physician office setting preferred
• Basic math skills and accurately process money transactions (must be able to read & understand an EOB)
• Experience with office equipment: multi-functional printer/copier/fax, multi-line phone system, calculator, postage machine, and so on
• Must be proficient using the computer, data entry, and have above average typing skills
• Experience with MS Office, EMR/EPM systems
• Experience with eClinical Works Practice Management system preferred
• Prior experience with ENT specialty a plus