Insurance Verification Specialist

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

📋 Description

• Process insurance claims and oversee patient accounts.

• Respond to questions regarding account status and charges from patients undergoing ophthalmology surgeries.

• Gather insurance information from surgery patients.

• Communicate with patients to provide cost estimates for day-of-surgery expenses.

• Record surgery charges and payments.

• Secure prior authorization for necessary procedures.

• Log customer interactions within the designated computer system.

• Input and submit professional and facility insurance claims.

• Manage claims through practice management and EHR systems.

• Confirm insurance eligibility, benefits, authorizations, coverage limits, and patient financial obligations.

• Clarify copays, deductibles, coinsurance, out-of-pocket costs, and coverage decisions.

• Follow up on denied, rejected, unpaid, or underpaid claims and resubmit as necessary.

• Record charges, insurance payments, patient payments, adjustments, and refunds.

• Submit secondary claims and handle coordination of benefits.

• Track and collect outstanding patient balances, including soft collection efforts.

• Carry out daily balancing tasks and maintain precise financial records.

• Ensure adherence to HIPAA regulations and payer guidelines.

• Achieve productivity, quality, and service benchmarks.

• Collaborate with providers, patients, insurance companies, and team members.

• Execute additional duties and special projects as assigned.

⛳️ Requirements

• High School Diploma.

• Proficient computer skills, including familiarity with a Windows Operating System, email, and data entry.

• Capability to reference ICD-10 diagnosis and CPT treatment codes from online resources or traditional coding references.

• Previous experience with medical billing software.

• Minimum of one year of insurance billing experience from a previous role.

• Two years of experience in a medical office environment.

• Prior experience in an Optometry/Ophthalmology practice.

• Familiarity with Compulink software.

• Willingness to undergo a background check.

• Annual compliance training is mandatory.

• Compliance with HIPAA, OSHA, and company policies is essential.

• Ability to remain seated for prolonged periods.

• Frequent use of hands, fingers, and computer equipment.

• Effective communication skills with patients and team members.

• Ability to occasionally lift, carry, push, or pull items weighing up to 25 pounds.

🏝️ Benefits

• Paid Training & Career Development.

• Growth & Advancement Opportunities.

• Supportive Team Environment.

• Competitive Benefits Package.

• Tuition Reimbursement Opportunities.

• Employee Eyewear Discounts.

• Referral Bonus Program.

• Medical, Dental & Vision Insurance.

• 401(k).

• Paid Time Off & Holidays.

• Life & Disability Insurance.

• Tuition Reimbursement.

• Continuing Education Support.

• Certification Sponsorship.

• Referral Bonus Opportunities.