Skip to main content

Insurance Verification Specialist

Category:

Family Practice Providers

Department:

Family Practice Providers

Description:

Ensures that all patients with Insurance are verified and accurate information is collected to ensure accuracy during patient check in. Ensures the patient demographics are correct before patient’s appointment.

Essential Duties and Responsibilities:

Insurance Verification
-Runs schedules for all physicians twice each day, reviews for accuracy and reports inaccuracies to Clinic Manager.
-Verifies the insurance of each patient using Rycam, Payer Gateway, TMHP, Availity or individual insurance website; calling insurances when necessary to determine copays and
or deductibles.
-Documents all necessary information in the MPI Insurance Tab, and the appointment screen as necessary for accurate patient check in
-Ensures patients have the correct PCP listed on insurance policy; initiates referral process from PCP to treating physician when necessary

Scheduling
-Takes incoming calls regarding clinic and outpatient procedures; makes outbound calls to patients for appointment confirmation as back up to the scheduling team.
-Interviews patient or representative to obtain and record name, address, date of birth, emergency contacts, attending provider, and individual or insurance company responsible for payment of bill
-Explains clinic regulations such as payment of services, fee schedule and clinic procedures
-Enters patient admitting information into computer and books appointments
-Ensures the speaker is the patient or legal guardian when necessary
-Compiles data for census records
-Manage and resolve customer complaints
-Route calls to appropriate destination

-Follow up patient calls when necessary
-Completes Call Logs
-Monitors the day to day productivity of the Scheduling Department.

Education and/or Experience
One year certificate from college or technical school; or three to six months related
experience and/or training; or equivalent combination of education and experience.

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, national origin, sexual orientation, gender identity, marital status, disability, protected veteran status, or any other characteristic protected by law. Medina Healthcare System is a drug-free and tobacco-free employer with smoke free campuses. This job description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

Closing:

Open until filled

Apply for this job