Insurance Verify Rep

The Insurance Verification Specialist, under the direction of the PAU Manager or Supervisor, verifies benefit coverage, medical necessity, authorization, and referral requirements. This position supports our Shared Services Center and client hospitals around the country for a wide variety of payors and patient types by providing top-notch support to the entire revenue cycle. Essential Duties and Responsibilities: • Verifies detailed insurance benefits, medical necessity, and authorization/referral guidelines, consistently prioritizing and following the established verification processes. • Communicates outstanding documentation requests, required account follow-up, and payor issues to the appropriate facility contacts. • Responsible for maintaining performance standards that ensure the department is operating at peak proficiency and that established goals are consistently being met while maintaining effective communication with patients, physicians, medical office staff, and both internal and external co-workers. • Calculates the estimated patient financial responsibility via the estimation tool. • Notates all actions performed in the applicable host system(s) immediately. • Performs all other duties, as assigned or requested, while adhering to strict deadlines. Qualifications: • Required Education: High School Diploma or Equivalent • Required Experience: 1+ years of medical office, medical insurance company, or healthcare facility experience • Knowledge of CPT, ICD-10, and medical terminology • Required License/Registration/Certification: None • Preferred License/Registration/Certification: Certified Professional Coder (CPC) Apply Job!