Insurance Verification Specialist (Hybrid Schedule)

Remote Full-time
About the position

The Insurance Verification Specialist I position at 61st Street Service Corporation is a full-time role that involves verifying health insurance benefits for both new and existing patients. This position is currently hybrid due to Covid-19, requiring on-site work two days a week, with the possibility of changes based on training and business needs. The specialist will be responsible for contacting insurance companies to verify coverage levels and assisting patients in understanding their benefits. In cases where insurance does not cover certain services, the specialist will notify the patient and help arrange alternative payment methods. The role requires meticulous data entry to ensure that patient benefit information is accurately updated in the Electronic Medical Record (EMR) system. The specialist will also perform routine administrative tasks to support the smooth operation of the medical office. Maintaining service standards in accordance with departmental policies is essential, as is providing clear communication to patients regarding their insurance coverage and benefits. The specialist will consistently review eligibility responses in the insurance verification system and ensure timely verification of insurance coverage. Additionally, the role may involve requesting payments from patients and guarantors when appropriate, as well as performing other related duties as assigned within the scope of practice.

Responsibilities
• Verify patient insurance coverage to ensure necessary procedures are covered by the individual's provider.
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• Notify patients and help arrange alternative payment methods when insurance coverage does not cover services.
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• Enter data accurately to update patient benefit information in the EMR system.
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• Perform routine administrative and clerical tasks to maintain office operations.
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• Maintain service standards in accordance with departmental policies.
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• Answer patient questions to ensure understanding and satisfaction, referring them to senior staff when necessary.
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• Review eligibility responses in the insurance verification system consistently.
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• Verify insurance coverage in a timely manner.
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• Request payments from patients and guarantors where appropriate.
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• Perform related duties as assigned within the scope of practice.

Requirements
• High school diploma or GED certificate is required.
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• A minimum of 6 months' experience in a physician billing or third-party payer environment.
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• Demonstrated working knowledge of contracts, insurance benefits, exclusions, and billing requirements.
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• Ability to understand and navigate the payer adjudication process.
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• Strong customer service and patient-focused orientation with effective communication skills.
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• Ability to multi-task, prioritize, and manage time effectively.
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• Functional proficiency in computer software skills, including Microsoft Word, Excel, and Outlook.

Nice-to-haves
• Experience in front desk operations is preferred.

Benefits
• 401(k)
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• Dental insurance
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• Disability insurance
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• Employee assistance program
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• Employee discount
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• Flexible spending account
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• Health insurance
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• Life insurance
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• Paid time off
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• Tuition reimbursement
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• Vision insurance

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