Job Description

Position Summary:
The Insurance Verification Specialist plays a key role in supporting accurate and timely medical billing by verifying insurance coverage and benefits for patients. This position involves direct communication with insurance providers and patients to confirm eligibility, secure necessary pre-authorizations, and assist in resolving coverage discrepancies. The ideal candidate will possess strong attention to detail, excellent communication skills, and a thorough understanding of healthcare insurance processes.

• Confirm patients’ insurance coverage and plan details, including deductibles, copayments, and coverage limits.
• Obtain prior authorizations for medical services and procedures as required by insurance carriers.
• Navigate insurance portals to access policy information and secure necessary documentation.

Patient & Provider Communication:

• Serve as a point of contact for patients regarding their insurance benefits and potential out-of-pocket costs.
• Communicate clearly and professionally with insurance representatives and healthcare providers to resolve coverage issues.

Billing Support & Data Management:

• Assist in the collection and organization of insurance and patient data to ensure timely and accurate claims submission.
• Enter and maintain up-to-date information in the electronic health records (EHR) system with a high level of accuracy.
• Support the billing department with administrative tasks and special projects as assigned.

Minimum Qualifications (Knowledge, Skills, and Abilities):

• High School Diploma or equivalent is required.
• Reliability
• Ability to Multitask
• Must be able to work at all locations as needed.
• Knowledge of customer service principles and practices.
• Possession of strong problem solving skills and sound judgement
• Ability to collaborate across departments and build effective relationships with patients to achieve goals.
• Ability to work independently on assigned tasks as well as to accept direction or given assignments.
• Ability to be proactive and take initiative.
• Exhibit high level of quality through attention to detail.
• Must be able to exhibit patience.
• Deals with confidential information and/or issues using discretion and judgement.

Work Environment:

• Work is performed in a medical office setting.

Physical demands of position:

• Must be able to stand and walk for long periods of time.
• Must have manual dexterity to work with ophthalmic equipment and maneuver a patient if in a wheelchair.
• Must be able to accurately type information into EMR system.
• Must be able to have face to face conversation with patients and staff.

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