Verification Specialist - Skilled in portals, EMR?/EHR systems

Position: Insurance Verification Specialist - Skilled in insurance portals, EMR/EHR systems
Location: Georgia Center

Brunt Work | Full time: 35 paid hours per week or more
• Job Category:
Human Resources and Recruitment
• Work Timezone:
Georgia, US (EST)
• Work Schedule:

Fixed Schedule
• Job Type: Full time
• Date Opened: 01/20/2025
• Remote Job
• Industry: Other
Job Description

This is a remote position.

Schedule:

40 hours per week
Mon - Fri 8 AM- 5 PM Georgia, US Time (8 PM to 5 AM PHT) includes 1h unpaid break.

Job Summary:
The Insurance Verification Specialist is responsible for ensuring the accuracy and completeness of insurance coverage information for patients. This role plays a vital part in the revenue cycle process by verifying benefits, securing authorizations, and resolving coverage issues to facilitate timely payment for services rendered.

Key Responsibilities:

Insurance Verification:
• Confirm patient insurance eligibility and benefits through online portals, phone calls, or electronic systems.
• Identify coverage limitations, deductibles, co-pays, and out-of-pocket responsibilities.

Authorization Management:
• Obtain pre-certifications and prior authorizations for scheduled procedures or treatments.
• Track and follow up on pending authorizations to avoid delays in patient care.
• Inform patients of their insurance coverage, out-of-pocket costs, and any issues with their policy.
• Address patient inquiries regarding insurance verification in a professional and empathetic manner.

Documentation and Records:
• Accurately input verified insurance information into the patient management system.
• Maintain detailed records of verification and authorization activities.
• Work closely with clinical, billing, and scheduling teams to resolve discrepancies or coverage issues.
• Liaise with insurance companies to clarify coverage details and resolve conflicts.

Compliance:
• Ensure adherence to HIPAA regulations and company policies when handling sensitive patient information.
• Stay updated on changes in insurance policies and guidelines.

Qualifications: • Education: High school diploma or equivalent; post-secondary education in healthcare administration is a plus.

Experience:
• Previous experience in insurance verification, billing, or a related healthcare field preferred.
• Familiarity with medical terminology and coding (CPT, ICD-10) is advantageous.

Skills:
• Strong attention to detail and accuracy.
• Excellent communication and interpersonal skills.
• Proficiency in using insurance portals, EMR/EHR systems, and Microsoft Office Suite.
• Ability to work in a fast-paced environment and manage multiple tasks.
• Problem-solving and critical-thinking skills.
• Time management and organizational skills.
• Team-oriented mindset with a customer-focused approach.
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