Insurance Claims Specialist – HB
WVU Medicine
Insurance Verification Coordinator
CarepathRx
full-time
Posted on:
Location Type: Remote
Location: Remote • Pennsylvania • 🇺🇸 United States
Visit company websiteJob Level
Junior
About the role
- Manage the daily functions of the Insurance Verification area including verification of insurance coverage, re-verifying coverage for existing patients, enter and update patient demographics into the computer system, and securing reimbursement related paperwork
- Generate price/coverage quotes
- Work effectively and maintain expected productivity
- Verify insurance coverage, calculate costs and document details in the patient profile
- Generate a financial responsibility letter
- Review benefits with patient via phone
- Track, monitor and secure necessary insurance documents
- Obtain prior authorizations as required
- Coordinate completion of Financial Assistance forms, payment agreements and waivers
- Assist with training new employees
- Organize and prioritize tasks to be completed
- Create new hospital and physician codes as needed
- Give high priority to client satisfaction and customer needs
- Cooperate with other staff members when planning and organizing reimbursement activities
- Demonstrates the ability to work effectively and maintain expected productivity
- Meets quality standards, shows pride in performance, and demonstrates reliability and follow-through on all assigned tasks
- Assist with researching reimbursement issues
- Performs in accordance with system-wide competencies/behaviors
- Performs other duties as assigned
Requirements
- HS diploma or GED required
- 1+ year of insurance verification, prior authorization or other related experience in a physician practice, ancillary provider, or other relevant healthcare setting required
- Knowledge of medical terminology required
- Knowledge of payer websites, eligibility, coordination of benefits preferred
- Knowledge of pharmacy vs medical payers and authorization preferred
- Knowledge of plan formularies and authorization requirements preferred
- Proficient computer skills and Microsoft Office Products required
- Excellent math skills.
Benefits
- Medical, Dental and Vision Benefits for you and your family
- Paid Company Holidays
- Paid Time Off and Volunteer Time Off
- 401(k) with Company Match
- Company-paid Life Insurance and Disability Benefits
- Supplemental Insurance packages
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
insurance verificationprior authorizationmedical terminologycost calculationfinancial responsibility documentationpatient demographics managementhospital and physician codingreimbursement issue researcheligibility coordinationplan formularies knowledge
Soft skills
client satisfactionorganizational skillsprioritizationteam cooperationtrainingproductivityreliabilityperformance pridecommunicationproblem-solving
Certifications
HS diplomaGED
