Insurance Verification Specialist - Troy Gastroenterology

Company Description

The physicians and staff of the Center for Digestive Health specialize in gastroenterology, which covers all aspects of the digestive system. Our specialty includes diagnostic endoscopic procedures and ultrasounds, liver disease studies, reflux diagnosis and management, and motility studies.

We are dedicated to conducting the highest quality of clinical research, while offering to our patients an option to participate in some of the nation's leading and innovative gastrointestinal research studies.

Job Description

The Insurance Verification Specialist will go over patient insurance information and verify in advance the procedures/treatments that their policies will cover. They then call insurance companies and send the proper documentation to verify authorizations for procedures which require them. The Insurance Verification Specialist reports to the Billing Manager.

Essential Job Functions and Responsibilities

•    Enter data and validate patient information.
•    Researches and corrects invalid or incorrect patient demographic information such as invalid insurance policy number to ensure proper billing.
•    Verifies participating status of providers.
•    Determines member benefit coverage.
•    Monitor and verify insurance information for individual patient visits and procedures.
•    Communicate with patients about co-pays, benefits, coverage, and care authorization.
•    Contacts providers with authorization, denial, and appeals process information.
•    Assists in educating and acts as a resource to scheduling department.
•    Works and assists with the billing department in researching and resolving rejected, incorrectly paid, and denied claims as requested.
•    Responds professionally to all inquiries from patients, staff, and payors in a timely manner. 
•    Accurately documents patient accounts of all actions taken

Qualifications

•    High School Diploma or GED.
•    Demonstrated knowledge of insurances
•    1+ year experience in insurance verification, including navigating websites for online benefit review.
•    Knowledge of CPT and ICD-10 codes.
•    Excellent computer, multi-tasking and phone skills.
•    The ability to work well under pressure (most of the paperwork is time sensitive).
•    Must successfully pass a background check and drug screen.
 

Additional Information

In accordance with HIPAA, this position must maintain the confidentiality of the patient in all circumstances as well as company confidentiality. Ensures the confidentiality of data collected and stored is maintained. 

This description is intended to provide basic guidelines for meeting job requirements. Responsibilities, knowledge, skills abilities, and working conditions may change as needs evolve.

The Center provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. 

The Center complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities.