Insurance Verification Specialist

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Responsible for determining patient’s primary, secondary and tertiary insurance payer; verify patients’ benefits, eligibility, and seek authorization for services by contacting insurance companies; determine patient financial impact, if any, and inform them of any possible financial responsibility.

• Responsible for the timely verification of medical insurance benefits for new patients, existing patients with changes in insurance, and reactivated patients.
• Review and update patient accounts with insurance policy information and process requests accurately.
• Notate each account with a clear summary of patient eligibility and insurance benefits received from the carrier.
• Call government funded and commercial insurance companies to obtain prior authorizations or referrals.
• Determine the correct Coordination of Benefits.
• Complete verification requests confirming the correct network status through the company’s contracts with insurance payers to determine member benefit coverage.
• Ensure all insurance, demographic and eligibility information is obtained, and entered in the system in an accurate manner.
• Responsible for reviewing customer files for missing insurance information required to bill for services rendered.
• Perform financial review on existing accounts to identify benefit issues.