Insurance verification

Job Description

The Insurance Verification Coordinator (in office) facilitates accurate patient tracking and billing through verifying insurance benefits for new patients and referrals, updating information on existing patients, and obtaining pre-authorization for recommended services and procedures.

• Patient pre-registration : receives referral or request for treatment, obtains physician orders, if needed, and completes intake form.
• Patient insurance verification : verification of insurance coverage, including primary and secondary payers; verifies prior utilization and documents.
• Patient insurance authorization : provides required information for insurance authorization to the appropriate payer; researches any additional information required to obtain authorization, as needed.
• Clearly communicates the status of referrals including pre-registration, insurance verifications and authorizations to the appropriate clinic designee.
• Contact patient’s family / POA for consent to treat, if applicable.
• Faxes evaluations and other required paperwork, if applicable.
• Authorization for continued treatment : processes requests for coverage extension and all follow up as required. Tracks authorized visits, if needed.
• Manages all data input related to the verification and authorization process to ensure accuracy and timeliness.
• Efficiently distributes information including accurately filing information, screening and directing phone / fax information all in a timely and positive manner.
• Develops appropriate files, forms, databases using applicable computer software as directed.
• Manages time efficiently to ensure deadlines are met, tasks are prioritized, and special projects are completed.
• Communicates effectively with all staff.
• Promotes a safe work environment by maintaining work areas and equipment. Alerts supervisor or designee of unsafe equipment or working conditions.
• Knowledge of all emergency and safety policies and procedures, residents’ rights, HIPAA regulations, and accountability for information collected.
• Providing support for administrative tasks of the corporate home office.
• Other duties as assigned by supervisor.

Requirements

• High school diploma. Prior healthcare / office related experience preferred.
• Background in medical and insurance terminology desirable.
• Must be accurate, organized and self-motivated.
• Good with computer / software programs.
• Proficiency entering data into databases and running reports.
• Demonstrate considerable attention to detail.
• Ability to use Microsoft Office Word, Excel, and Outlook effectively and efficiently.
• Communicate effectively at all levels within the organization.
• Ability to handle confidential and sensitive information with discretion.

Last updated : 2024-05-13