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Insurance Verification Specialist

Insurance Verification Specialist

ID 
2018-1669
# of Openings 
1
Job Locations 
US-FL-Clearwater
Category 
Medical Insurance

More information about this job

Overview

The Insurance Verification Specialist with Medical Records requires general and specific knowledge data management, medical practice workflow and related activity. This job involves providing administrative assistance to the Operations, Clinical and Billing teams. Knowledge of health insurance plans, interpretation of health insurance benefits, prior authorization protocol, medical record indexing, scanning and duplication as requested.

Responsibilities

Essential Duties and Responsibilities:

  • Eligibility: effectively and accurately verify active health insurance information and interpretation of benefits utilizing EHR verification, SPOT, Availity and other payer sites, prior to service being rendered.
  • Account Maintenance: effectively and accurately create and maintain patient account information using face sheet and/or other data provided by servicing facilities.
  • Document Management in EHR: effectively and accurately scan and index health records including but not limited to: face sheets, progress notes, insurance verification forms, insurance cards, medical necessity orders and consent for treatment.
  • Prior Authorization: effectively and accurate determine if prior authorization is required by health insurance plans, request authorization contacting issuing provider and health plan, ability to thoroughly follow up through finalization process and maintain active authorizations in patient chart.
  • Willingness to learn and apply health service concepts as they relate to interactions with persons served.
  • Ability to communicate in a clear and effective manner, both orally and in writing.
  • Ability or willingness to learn, willingness to acquire function knowledge of software as needed.
  • Skill in clerical work: typing, data compilation, filing and including overall attention to detail and follow through.
  • Ability to maintain confidentiality.
  • Provide telephone and department support, as needed.
  • Performs other related clerical duties, as assigned.

Qualifications

Supervisory Responsibilities:   None

Qualifications:

  • Understanding and effective use of basic principles of administration in a healthcare environment.
  • Associates degree or equivalent job-related health care experience.
  • Experience in using electronic health record software, eligibility and electronic billing.
  • Strong computer skills in including proficiency using EHR, SPOT, Availity, Navinet and other payer sites.
  • Exceptional communication skills- both written and verbal.
  • Ability to read, understand, and adhere to CMS guidelines and compliance.
  • Superior organizational skill, attention to detail, ability to work without micro-management.

Certificates, Licenses, Registrations: None

 

Computer Skills:

  •  Proficiency using software programs such as MS Word, PowerPoint, Excel and Outlook 

 

Environmental Factors/Physical Demands:

 

Work is performed in an office environment. While performing the duties of this job, the employee is regularly required to have the ability to maintain active customer and employee communication; access, input and retrieve information from the computer system; enter alpha-numeric data into a computerized system often while listening on the telephone. May be subject to repetitive motion such as typing, data entry and vision to monitor. May be subject to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds.