Insurance Verification Specialist jobs in Columbus, OH
Insurance Verification Specialist is responsible for the pre-verification of insurance for patients being admitted into the hospital for care. Ensures insurance coverage by telephone, resolves any issues with coverage and escalates complicated issues to a supervisor or manager. Being an Insurance Verification Specialist interviews patients and completes all paperwork necessary to ensure the admitting process is efficient and all hospital and regulatory policies are in compliance. May require a bachelor's degree in area of specialty. Additionally, Insurance Verification Specialist typically reports to a supervisor or manager. To be an Insurance Verification Specialist typically requires 2 to 4 years of related experience. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. (Copyright 2024 Salary.com)
Recently Added Insurance Verification Specialist jobs
Insurance Verification and Prior Auth Specialist
- Ohio Gastroenterology Group, Inc.
-
Reynoldsburg, OH
FULL_TIME
-
Ohio Gastroenterology Group is the leading provider of general advanced GI procedures with several state-of-the-art facilities throughout Central Ohio. We employ a talented team of specialists who perform more GI procedures each year than any other practice in our area.We currently have a full-time opening for an Insurance Verification and Prior Auth Specialist.Duties and ResponsibilitiesPrimary Job Functions:
- Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicaid, and third-party payer requirements/on-line eligibility systems.
- Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for patients. Follows up with internal departments, physician offices, patients and third-party payers to complete the pre-certification process.
- Identifies out of pocket amounts (i.e., copay, deductible, co-insurance), determining the correct coordination of benefits, identifying if a replacement or supplemental plan exists, identifying termed coverage, and identifying if the patient's plan is considered out of network coverage.
- Collaborates with internal departments to provide account status updates, including expected out of pocket amounts, coordinate the resolution of issues, and appeal denied authorizations.
- Ensures services have prior authorizations and updates patients on their preauthorization status. Coordinates peer to peer review if required by insurance. Notifies ordering providers if authorization/certification is denied.
- May need to coordinate scheduling of patient appointments, diagnostic and/or specialty appointments, tests and/or procedures.
- Maintains files for referral and insurance information, and enters referrals into the system.
- Maintains knowledge of and reference materials of the following: Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization and a list of current accepted insurance plans.
- Runs system-generated reports to verify insurance verification/authorization is being done timely prior to the patient's date of service; verifies the insurance benefits and eligibility either by phone or online for every patient that is scheduled
- Responds to patient calls about how out of network insurance is handled and provide patient with letter explaining this if necessary.
- May need to respond to patient inquiries about their insurance benefits.
- Assists physician’s office staff with any insurance benefit questions and educate them on any changes to the insurance companies’ verification/pre-certification process for the facility.
- Ensures insurance information is verified and entered into the billing system.
- Works with Billing Department to assure all insurance information is entered so claims are not denied. May help research any claim issues.
- Other duties as assigned.
Secondary Job Functions:- Attend meetings and training sessions
- Maintain confidentiality of patient and financial information by utilizing HIPAA guidelines and regulations
- Adheres to all Federal, State, and Local laws and regulations as well as policies set forth by Ohio Gastroenterology Group Inc and its related parties
Knowledge, Skills and Abilities- Knowledge of third-party payers and prior-authorization requirements
- Understanding of basic medical terminology and procedures
- Proficient use of office equipment, such as copier and fax machine, phones, etc.
- Intermediate computer skills including use of Microsoft Office (Excel and Word), electronic mail, payer websites, physician practice management, and electronic medical records systems.
- Strong time management skills
- Ability to work independently with minimal supervision and to manage multiple priorities.
- Strong written and verbal communication skills
- Ability to effectively communicate with a variety of people under stressful circumstances.
- Neat appearance, professional demeanor and pleasant voice
- Fluent in English
Credentials and Experience- Must have high school diploma or equivalent
- One (1) year of experience and relevant knowledge of revenue cycle functions, insurance eligibility, or prior authorization in a healthcare setting preferred
- Experience with eClinicalWorks a plus
Physical Demands- Must be able to bend over (frequent), climb stairs (frequent), sit (frequent), stand (frequent), stoop (frequent), walk (frequent) and type on keyboard (frequent).
Work Environment- Minimal medical office exposure that may require contact with adult patients
- Office workstation environment with numerous employees
Ohio Gastroenterology Group offers a nice life/work balance and a great benefits package that includes:- Medical, dental and vision coverage- benefits are effective the first of the month following 30 days of employment
- Company paid life insurance and short term disability
- Generous paid time off plans (vacation, sick and personal)
- 7 paid holidays
- Two retirements plans:
- 401(k) plan that offers a 3% safe harbor contribution with immediate vesting as well as annual profit sharing contributions.
- Cash balance pension plan – company contributes 2.5% and offers full vesting after 3 years of employment.
- Tuition reimbursement programs
- Employee appreciation programs
- Uniform reimbursement programs
- Growth opportunities
- Learning and development training
Apply now to join a great company! - 27 Days Ago
Operational Excellence Specialist
- Grange Insurance
-
Columbus, OH
FULL_TIME
- Ready to be a part of our Team? Grange Insurance provides more than peace of mind and protection during life’s unexpected events. Named “Top Workplace in Columbus,” in 2023, Grange encourages Associat...
- 19 Days Ago
Claims Supplier Management Specialist
- Central Mutual Insurance Company
-
Dublin, OH
FULL_TIME
- Location: Hybrid Work Model We are a team of employees who are passionate to deliver best in-class customer service and innovation in the industry. It's because we put Integrity, Relationships and Exc...
- 13 Days Ago
Property Field Claims Specialist
- Central Mutual Insurance Company
-
Dublin, OH
FULL_TIME
- Location: Remote The Property Field Claim Specialist position is an exciting opportunity for a dynamic, motivated, and experienced individual. The ideal candidate will embrace Central's mission of pro...
- 19 Days Ago
Property Claims Specialist
- EMC Insurance Companies
-
Columbus, OH
FULL_TIME
- At EMC, you'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success. EMC strives to hire and retain ...
- 1 Month Ago
AWS Certified Welding Inspector
- HRV Conformance Verification Associates, Inc.
-
Columbus, OH
FULL_TIME
- HRV Conformance Verification Associates, Inc. supplies a highly integrated series of professional engineering and quality assurance/quality control services worldwide that span the steel, concrete, pa...
- 4 Days Ago
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0 Insurance Verification Specialist jobs found in Columbus, OH area
Front Desk Agent
- Doubletree Columbus
-
Columbus, OH
- Property Description: DoubleTree Columbus, located in the vibrant city of Columbus, Ohio, is seeking talented individual...
- 4/19/2024 12:00:00 AM
Non CDL Driver Apprentice
- Pitt-Ohio Express Llc
-
Columbus, OH
- Requisition Number: 2022-0232-COL-POE Job Title: Non CDL Driver Apprentice City: Columbus State: OH Pay Scale: $21.21_ *...
- 4/19/2024 12:00:00 AM
Medical Assistant
- Carbon Health
-
Columbus, OH
- As a physician-founded and led organization, ensuring everyone has access to quality healthcare is what inspires us. Tha...
- 4/19/2024 12:00:00 AM
Construction Project Manager II - Mission Critical (Traveling)
- RYAN COS. US INC
-
Columbus, OH
- Ryan Companies US, Inc. has an immediate career opportunity for a Construction Project Manager II to join our National t...
- 4/19/2024 12:00:00 AM
Claims Examiner –Remote
- Generis Tek Inc
-
Columbus, OH
- Please Contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Abhinav Chakraborty ...
- 4/18/2024 12:00:00 AM
Insurance Servicing Agent
- Associated Insurance Agencies
-
Westerville, OH
- Job Description Job Description The Insurance Servicing Agent at Associated Insurance Agencies is responsible for mainta...
- 4/18/2024 12:00:00 AM
Sr. Workers' Compensation Claims Adjuster Ohio Lic a must
- North American Risk Services, Inc. (NARS)
-
Columbus, OH
- Job Description Job Description Senior Workers Compensation Claims Adjuster NARS is building a new team consisting of se...
- 4/18/2024 12:00:00 AM
Chiropractic Therapy Tech/Insurance Verification Specialist
- LOVE CHIROPRACTIC CARE INC.
-
Grove City, OH
- Job Description Job Description Progressive chiropractic practice focused on providing the community with chiropractic c...
- 4/16/2024 12:00:00 AM
About Columbus, Ohio
The confluence of the Scioto and Olentangy rivers occurs just north-west of Downtown Columbus. Several smaller tributaries course through the Columbus metropolitan area, including Alum Creek, Big Walnut Creek, and Darby Creek. Columbus is considered to have relatively flat topography thanks to a large glacier that covered most of Ohio during the Wisconsin Ice Age. However, there are sizable differences in elevation through the area, with the high point of Franklin County being 1,132 ft (345 m) above sea level near New Albany, and the low point being 670 ft (200 m) where the Scioto River leaves...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Insurance Verification Specialist jobs
$36,386 to $45,842
Columbus, Ohio area prices
were up 1.3% from a year ago
were up 1.3% from a year ago
What does an Insurance Verification Specialist do?
Insurance Verification Specialist in Saint Louis, MO
The section work experience is an essential part of your insurance verification specialist resume.
December 01, 2019
Insurance Verification Specialist in Laramie, WY
Wide experience with all public and private health insurance practices and policies.
February 04, 2020
Insurance Verification Specialist in Mobile, AL
Key skills listed on a resume include – insurance claims expertise, experience working with insurance companies; extensive knowledge of different types of coverage and policies, excellent multitasking skills, and the ability to maintain accurate patient insurance records.
January 20, 2020