Insurance Verification Support Specialist

Position Overview: Reporting to the Director of Centralized Insurance Verification – Enterprise RCM, the Insurance Verification Support Specialist is responsible for verifying insurance coverages, obtaining initial Preauthorizations, and ensuring accurate data collection and entry for assigned locations. The role involves streamlining processes and delivering efficient insurance verification services.

Responsibilities:

• Maintains current knowledge of patient scheduling, registration/intake processes and systems, medical necessity review, insurance eligibility verification and authorization, and billing models.
• Performs insurance verification process and documents benefits, patient information, and patient responsibility based on insurance contracts.
• Enters complete and accurate information into computer systems to avoid mistakes and ensure clean claims.
• Verifies that procedures scheduled are covered by the payer when performed in an ASC.
• Uses available calculators like Medicare, workers compensation, etc., accurately.
• Calculates allowable amounts as directed by management.
• Demonstrates effective critical thinking, problem solving, and decision-making skills.
• Handles a heavy workload and multiple requests positively, establishing priorities for effective completion.
• Adapts quickly to changing conditions and assimilates new processes into job functions.
• Other duties as assigned.

Required Skills:

• 2-5 years of verification, authorization, or scheduling experience. Ambulatory Surgery Center experience is preferred.
• Working knowledge of accessing benefits from various sources.
• Ability to interpret benefits and calculate allowable/patient responsibility amounts.
• Sound judgment and strong interpersonal skills.
• Effective verbal and written communication skills.
• Capability to multi-task and meet deadlines.
• Ability to work independently and as part of a team.
• Knowledge or experience with various healthcare insurance payers is preferred.
• Proficient in Microsoft Office, especially Excel and Outlook.
• Experience with Advantx, gMed, HST, Waystar preferred.
• High School Diploma or equivalent.