Verification Specialist Position Summary
The Verification Specialist is responsible for the end-to-end process of verifying patient benefits through research that includes all device types, insurance plans and government plans. The Verification Specialist resolves enrollment deficiencies and secures payer information for the proper billing of services.
- Research and resolve a daily average of 35 – 45 routine and complex enrollment or billing issues due to lack of information or incorrect information. The accounts must be worked to conclusion (billing).
- Contact practices to complete enrollment and/or obtain the correct insurance information.
- Contact patients to obtain information necessary to complete enrollment or verify insurance.
- Contact various insurance companies either by phone or web site portals to obtain insurance benefit details.
- Contact primary or secondary insurance companies to verify eligibility and/or coverage.
- Create or complete new patient accounts in Centricity using enrollment/verification forms.
- Obtain authorizations on accounts as needed.
- Electronically note accounts for various reasons, including; but not limited to, inability to verify; special instructions from the physician/practice; incomplete verification; and similar issues.
- Utilize the Customer Relationship Management System, Centricity and related systems in order to locate missing patient information not listed on the enrollment form received.
- Work accounts diligently based on the expected quota and quality standards in order to close the month timely.
- Work closely with other departments as deemed necessary in order to accurately prepare the account for billing.
- Employee may be required to actively participate in team meetings.
- Other duties as assigned.
- 1-2 years related experience preferred
- Ability to learn about various types of insurance plans, inclusive of government plans
- Ability to speak with various insurance company representatives to obtain patients’ benefits
- Professional tone and speech are required
- Must adhere to strict confidentiality and governmental HIPAA requirements
- Ability to learn new software programs
Ability to navigate various insurance websites
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