Insurance Change Specialist

Job Description

Duties:

Obtains patient demographic and health insurance information; collects co-pay(s) when appropriate.

Verifies and records insurance benefits with the ability to understand and provide insurance breakdowns.

If required by payer(s), obtains prior authorization &/or follows up on authorization daily.

Able to read through and understand medical documentation effectively

Resolves Front Collections accounts as well as documenting within computer system appropriately.

Establishes and maintains effective communication and good working relationships with patients/family, physicians’ offices, and other internal teams for the patient’s benefit.

Performs other clerical tasks as needed, such as

Answering patient/Insurance calls

Faxing and Emails

Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Revenue Cycle Manager and Supervisor

Other responsibilities and projects as assigned.

Requirements:

High School Diploma or equivalent.

Learns and maintains knowledge of current patient database and billing system

Verifying Insurance for all products

Understand Insurance benefit breakdown of deductibles and co-ins

Understand Insurance Medical and Payment Policies

Knowledge of Explanation of Benefits from insurance companies

General knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid

Working knowledge of CPT and ICD-10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.

Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.

Utilizes initiative while maintaining set levels of productivity with consistent accuracy.

Experience:

2-4 Years in DME or Medical Office experience preferred.

Minimum of 1 year of insurance verification or authorizations required.

Skills:

Superior organizational skills.

Proficient in Microsoft Office, including Outlook, Word, and Excel.

Attention to detail and accuracy.

Effective/professional communication skills (written and oral)

Full-time