REMOTE Insurance Verification Specialist
Posting ID: 7304190
This role REQUIRES experience within insurance verification!
- Responsible for verifying patient eligibility, coordinating benefits, running test claims and determining patient coverage/responsibility for services including, but not limited to primarily major medical insurance benefits verification, complex insurance plan verification and high volume PBM plans.
- The IVS needs to understand and work with J-Codes, diagnosis codes, route of administration, place of service, IPA claims, Medicare B & D billing, Major Medical, and PBM.
- Understanding the authorization process is a must.
- The IVS will also be responsible for the coordination of benefits investigation and partnering with patient assistance programs.
- May also assist with testing and implementation of new planned business.
- Utilizes all available resources to obtain and enter insurance coverage information for ordered services into patients file.
- Verifies patient insurance coverage of medications, administration supplies and related pharmacy services through proper investigation into either major medical benefits (including Medicare) or pharmacy benefits.
- Facilitates and completes the prior authorization process with insurance companies and practitioner offices.
- Completes a full Medical Verification for all medications, administration supplies and related pharmacy services.
- Notifies patients, physicians, practitioners and/or clinics of any financial responsibility of services provided and requested services that are not provided by the facility.
- Facilitates pharmacy and/or major medical claims with insurance companies and practitioner offices and investigates and facilitates prior authorization and any other claim rejections.
- Provides notification of urgent orders to the Senior level or Group Supervisor and communicates with other departments when an urgent need for filling a prescription or delivery is necessary.
- Places outbound calls to patients or physicians offices to obtain additional information needed to process the script or to notify of delay in processing script.
- Manages inbound calls on the Insurance line from patients, clients, physicians, practitioners and clinics regarding inquiries about services provided, financial responsibility and insurance coverage.stem.
We know that a company's success starts with its employees. We also know that an individual's success starts with the right career opportunity. As a Best of Staffing® Client and Talent leader, Aerotek's people-focused approach yields competitive advantage for our clients and rewarding careers for our contract employees. Since 1983, Aerotek has grown to become a leader in recruiting and staffing services. With more than 250 non-franchised offices, Aerotek's 8,000 internal employees serve more than 300,000 contract employees and 18,000 clients every year. Aerotek is an Allegis Group company, the global leader in talent solutions. Learn more at Aerotek.com.
Recruiter: Colleen Eifler
Phone: (312) 601-2608