Insurance Specialist

Responsibilities for Insurance Specialist

• Obtain and verify insurance authorizations for office appointments and procedures
• Responsible for ensuring insurance companies and medical practices are contacted to complete the verification process through phone calls and/or web based sites and responsible for obtaining authorizations/ pre-certifications in a timely manner
• Interfaces with the primary care office and patients regarding any pre-certification issues, verify eligibility and confirms authorization on file
• Ensures authorizations /pre-certifications issued are correct
• Documents the insurance and authorization verification information in the applicable computer system in accordance with documented work processes
• Deals with fair share of payors and will be responsible to get denials turned around quickly

Qualifications for Insurance Specialist

• Prior insurance verification experience required, at least two years preferred
• Computer literacy required, experience with medical scheduling/billing systems is required
• Utilize appropriate communication system to facilitate communication with facility and other departments as required
• Provides support for the scheduling and pre-registration departments as needed
• Collaborate with billing staff to ensure proper billing and reimbursement processes
• Acts as source of reference for team members