Insurance Verification Rep

Department

Integrated Case Management

Responsible for obtaining accurate health insurance benefits verification of eligibility status and assist with authorizations using electronic verification systems or by contacting payers directly to determine level of insurance coverage. Ensures the pre-registration process is complete for all assigned accounts at least 7 days prior to the scheduled date of service whenever possible. Identifies copayments, coinsurance, and policy limitations, and advises patient and collects amount before the time of service.

Follows up on missing authorizations. If authorization is not obtained within 48 hours prior to service, contacts patient to advise them of their options for rescheduling/follow‑up with physician’s office or proceeding without authorization.

• Require a minimum of one (1) to two (2) years of medical insurance verification / authorizations experience.
• Require a general knowledge of medical terminology.

• Prefer typing skills minimum thirty (30) words per minute.
• Prefer working knowledge of ICD-9/ ICD-10 and CPT coding.
• Prefer demonstrated excellent customer service skills and phone etiquette skills.
• Prefer basic working knowledge of commonly used computer applications.
• Prefer general knowledge of medical terminology.
• Prefer the ability to communicate clearly and effectively; excellent written skills and spelling/grammar.
• Prefer experience in patient interviewing.
• Prefer prior demonstrated customer‑centered service experience and ability to be flexible with changing priorities, demands and requests.
• Prefer demonstrated flexibility and adaptability.
• Prefer strong organizational skills.

HS EQ:
High School Diploma, GED or Certificate

AD:
Associate's Degree

CHAA:
Certified Health Access Assoc