Insurance Eligibility Verification Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Responsible for confirming patients' insurance coverage, including benefits, and securing pre-authorizations for services.

• Collaborates effectively within a team and communicates proficiently.

• Aids practice staff with eligibility inquiries as required.

• Acts as a liaison between the Revenue Cycle Management (RCM) department and various PTC facilities.

• Manages a high volume of incoming and outgoing calls for patients needing financial and medical screenings for assistance programs.

• Performs benefits verification for multiple clients within designated timelines.

• Upholds superior customer service standards in alignment with federal and state regulations and guidelines.

• Provides regular updates on processing status.

• Aids in investigating reimbursement concerns related to benefits and eligibility issues.

• Participates in the training of new team members.

• Inputs and updates patient demographic information in the billing system as required.

• Completes Key Performance Indicator (KPI) reports as requested by management and clients.

• Updates and oversees the Verification of Benefits (VOB) tracker for multiple clients.

• Possesses an understanding of federal and state regulations regarding client confidentiality and the principles of safeguarding protected health information (PHI).

• Works efficiently while maintaining expected productivity levels.

• Undertakes additional tasks or responsibilities as assigned.

⛳️ Requirements

• Associate’s degree is preferred or relevant experience may be considered in lieu of a degree.

• 1-2 years of experience in front-end medical office operations.

• Previous experience in a position involving a high volume of either inbound or outbound calls.

• Knowledge of federal or state government agencies such as Social Security, Medicaid, and/or Commercial coverages, along with familiarity with the healthcare revenue cycle as it pertains to patient accounts.

• Experience in roles requiring the ability to prioritize multiple critical tasks while ensuring quality and meeting performance metrics.

• Proficient in customer interactions that necessitate live and accurate documentation of encounters.

• Prior experience in collecting patient payments or copays.

🏝️ Benefits

• 18 days of Paid Time Off (PTO) plus 8 paid holidays.

• 401k plan with company matching.

• Ongoing training and certification opportunities sponsored by the company.

• Comprehensive benefits package, including medical, dental, vision, short-term disability, long-term disability, and accident insurance.

• Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP).

• Discounted tuition and scholarships available through Capella University.