Insurance Authorization Specialist – Bedded
Ensemble Health Partners
Insurance Verification Specialist
City of Hope
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
Junior
About the role
- Reviews and evaluates prospective and current patients' insurance coverage
- Obtains benefits via 40+ question interview process or online payer portals for hospital and physician services (inpatient/outpatient, in/out of network)
- Documents patient benefits in database repositories to support accurate billing and reimbursement
- Verifies new patient verifications and completes return verifications from work queues, email and SharePoint requests
- Verifies returning patients for continued benefit evaluation per financial policy
- Completes a required minimum number of records per day and provides daily counts via email
- Evaluates and estimates insurance policy coverage adhering to Patient Financial Acceptance Policy and site exceptions
- Performs initial financial screens to maximize reimbursement and minimize uncollectible balances
- Interprets and communicates insurance benefits to OIS, care managers, registration, billing, CFOs, and other stakeholders
- Completes administration exceptions and verifies Medicare via online tools
- Sends Journey Book tasks or emails regarding administration exceptions, benefits changes, coverage termination, and pre-certification requirements
- Advises leadership of updates needed to insurance verification alert list and noticeable insurance trends
- Reports to the Advocate, Patient Access Supervisor and communicates daily with multiple internal stakeholders
Requirements
- Must be a high school graduate or equivalent
- Associates Degree preferred
- Recommended minimum of 1-3 years experience in insurance verification, insurance benefits, registration, billing and/or collection in a healthcare / physician office setting or professional environment
- Preferably possesses basic knowledge of medical terminology
- Preferably possesses good written and verbal communication skills
- Must have experience utilizing PC and other office equipment
- Must have good working knowledge of Operating Systems to include Microsoft Office Suite
- Prefer ICD-9, CPT coding, and ability to read Explanation of Benefits
- Highly recommend understanding and experience with insurance terminology
- Must have outstanding telephone communication and customer service skills
Benefits
- To learn more about our comprehensive benefits, click here: Benefits Information
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
insurance verificationinsurance benefits evaluationbillingcollectionICD-9 codingCPT codingmedical terminologydata documentationfinancial screeningreimbursement maximization
Soft skills
written communicationverbal communicationcustomer serviceinterpersonal skillsorganizational skillsleadership communicationstakeholder communicationattention to detailproblem-solvingtime management
Certifications
high school diplomaassociates degree
