Medical Insurance Specialist // Sits In Colorado

Job Description:

• Initiate and/or maintain ongoing communication with facilities to ensure timely, accurate receipt of patient insurance coverage information
• Verify patient insurance with payors including eligibility and benefits related to outpatient kidney dialysis
• Update Patient Registration and associated systems accurately and as required
• Coordinate and partner closely with Patient Referral Coordinators (PRC) to obtain required documentation for successful patient registration
• Partner with facility and Insurance Management Team to resolve incomplete registrations
• Resolve patient account errors that cause registration denials
• Help identify process changes to prevent failed registrations
• Determine Coordination of Benefits as required; maintain current patient account information at all times
• Submit internal requests including but not limited to RCUs, SMARTFORMS, PCS Inquiries, SPA Requests, etc. to ensure accurate and timely claims submission to the correct payors
• Complete all ancillary reports and assigned projects within established timeframes
• Maintain confidentiality of all company and patient information in accordance with HIPAA regulations

Qualifications:

• MUST HAVE BENEFIT VERIFICATION EXPERIENCE
• Basic computer skills and proficiency in MS Word, Excel, and Outlook require
• Minimum of three (3) years’ healthcare reimbursement experience preferred; experience with admissions, billing, and collections required
• Demonstrated knowledge of insurance rules, regulations and Coordination of Benefits for federal, state, and/or managed care payors in multiple states required