Insurance Verification Specialist

Description

• Initiates and facilitates the predetermination process: All candidates must have pre-qualification experience Insurance verification experience
• Contacts appropriate insurance companies for benefit verification and pre-certification of surgical and nonsurgical procedures; notifies the financial counselor for prepayment of uncoded services
• Supplies all documentation required during the pre-certification process to insurance companies
• Maintains daily surgery/procedure schedule for department faculty; maintains open communication with physicians and their assistants regarding their schedules
• Maintains written log of all pre-certifications in process; notifies hospital utilization/billing department of pre-certification
• Documents are received when pre-certification is received from insurance companies

Hours: M-F 8AM-5PM CST

Skills & Qualifications:

• Medical Terminology Proficiency
• Insurance Plan Knowledge (Commercial, Medicare, Medicaid)
• Prior Authorization Process Expertise
• Familiarity with CPT/HCPCS and ICD-10 Codes
• Electronic Medical Records (EMR/EHR) Experience (e.g., Epic, Cerner)
• Strong Verbal and Written Communication
• Attention to Detail
• Time Management and Prioritization
• Problem-Solving and Critical Thinking
• Customer Service and Patient Interaction
• Data Entry and Administrative Accuracy
• HIPAA and Healthcare Compliance Awareness

Experience Level

Expert Level