Priority Claims Specialist III
Hanger, Inc.
Insurance Verification Specialist
AdaptHealth
full-time
Posted on:
Location: 🇺🇸 United States
Visit company websiteJob Level
Junior
About the role
- Intake Specialist responsibilities: accurate and timely data entry; understanding, and selecting inventory/services in key databases; communicating with referral sources; utilizing technology to notate patient information/communication.
- Answer inbound calls and make outbound calls; obtain, analyze, and verify the accuracy of information received from referrals; create orders; schedule the patient to receive equipment as ordered by their doctor.
- Intake Specialists educate Patients of their financial responsibility when applicable.
- Review and enter referrals into appropriate systems; ensure documentation is routed to appropriate physician for signature/completion.
- Work with local branch leadership to ensure inventory/services are provided; support regional team functions as necessary.
- Verify insurance coverage, determine eligibility, co-insurances, and deductibles; obtain pre-authorization if required; process orders to carriers for approval; resolve coverage issues.
- Communicate with Customer Service and Management regarding trends with insurance companies; ensure QA and performance metrics are met
- Maintain knowledge of payer guidelines, payer coverage, and expiration dates as needed
Requirements
- High School Diploma
- 1 year of work experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry
- Experience in Medicare certified HME, IV or HH environment that routinely bills insurance (preferred)
- Ability to navigate multiple online EMR systems
- Excellent communication and customer service skills
- Proficient computer skills and knowledge of Microsoft Office
- Ability to understand payer guidelines and clinical documentation
- Ability to work in a fast-paced environment and manage multiple tasks
- Willingness to educate Patients about financial responsibility
