Insurance Verification Specialist

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

📋 Description

• Acquire and maintain an understanding of the current products and services provided by AdaptHealth.

• Assess required documentation for precision.

• Confirm patient insurance coverage, eligibility, co-insurances, deductibles, authorization needs, and coverage limitations.

• Secure pre-authorizations and process physician orders with insurance providers.

• Handle inbound calls and initiate outbound calls with patients, referrals, and insurance companies.

• Gather, evaluate, and authenticate referral information.

• Generate orders and arrange for patients to receive the necessary equipment.

• Inform patients about their financial responsibilities when applicable.

• Address coverage issues and escalate complex matters to a Manager.

• Input accurate patient demographic and insurance information into EMR databases.

• Navigate various online EMR systems and payer websites to secure documentation.

• Relay insurance trends to Customer Service and Management teams.

• Validate insurance carriers in the company database and request new entries as required.

• Reach out to patients when documentation fails to meet payer standards and provide updates or alternative options.

• Meet quality assurance standards and key performance indicators.

• Assist in resolving customer complaints and issues.

• Utilize company-provided resources, including Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI, PECOS, and instructional documents.

⛳️ Requirements

• High School Diploma or equivalent.

• One (1) year of relevant work experience in healthcare administration, finance, insurance customer service, claims, billing, call center, or management in any industry.

• A senior-level position requires two (2) years of relevant work experience and one (1) year of specific job experience.

• Competent computer skills and familiarity with Microsoft Office.

• Preferred general knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements.

• Exceptional customer service abilities.

• Strong analytical and problem-solving skills with a keen attention to detail.

• Excellent verbal and written communication capabilities.

• Ability to prioritize and handle multiple tasks effectively.

• Capability to learn new technologies and comprehend data flow through systems and their interactions.

• Ability to work independently as well as collaboratively within a team.

• Flexibility and adaptability in a dynamic environment.

• Willingness to work flexible hours of operation.

🏝️ Benefits

• Comprehensive health benefits.

• Paid time off and holiday pay.

• Retirement plan options.

• Opportunities for professional development and career advancement.