Insurance Verification Specialist jobs in Lexington, KY

Why Us?

With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics nationwide. Through its Products & Services segment, Hanger distributes branded and private label O&P devices, products and components, and provides rehabilitative solutions to the broader market. With 160 years of clinical excellence and innovation, Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value. Collectively, Hanger employees touch thousands of lives each day, helping people achieve new levels of mobility and freedom.

Could This Be For You?

Review patient information to ensure insurance coverage is active and contact health insurance companies to verify eligibility and benefits from within an organization that provides healthcare patient services. Work with third-party payers to obtain pre-certification/pre-determination/pre-authorization prior to delivery of scheduled devices and services. Document and maintain accurate registration and benefits information for patients complete and communicate current status of authorizations, claims, and appeals.

Your Impact

Principal Duties and Responsibilities (Essential Functions):

• Promote the values of Hanger
• Reviews documentation to ensure meets needs of payer and medical policy
• Verifies diagnosis code on patient billing is accurate and reimbursable
• Communicates with clinic staff to obtain necessary documentation
• Communicates with insurance companies to verify patient benefits
• Determine insurance financial information such as coinsurance, deductible, etc. used to determine patient responsibility
• Coordinate with clinic if items are determined to be not covered
• Submit authorization request to insurance companies and follows up as needed
• Ensures authorizations provided by insurance companies are accurate and contain correct codes, quantities and appropriate authorization date ranges.
• Updates patient chart with necessary notations, authorization numbers, and documentation
• Contact third-party payer to validate patient’s coverage
• Contact patient for updated insurance information
• Perform other duties as assigned

Minimum Qualifications

Experience and Education:

• High school diploma or equivalent
• Less than 1 year of related experience

Preferred

• Medical terminology knowledge
• Pre-Authorization knowledge/experience
• Knowledge of insurance payer requirements
• Experience with EMR systems (NextGen and/or OnBase)
• Basic computer knowledge
• DME/Orthotic knowledge  

Additional Success Factors

Knowledge and Skill:

• Able to initiate communication with clinic staff and insurance companies
• Excellent customer service and communication skills
• Able to manage multiple responsibilities and to prioritize duties/tasks in a fast paced working environment
• Good interpersonal, oral and written communication skills, including the ability to follow written and verbal directions
• Resourceful and flexible team player who excels at building trusting relationships with patients, referral sources and colleagues
• Working knowledge of HIPAA and other medical insurance regulations and terminology for private payer, state and federal plans including coding, billing and reimbursement protocols
• Working knowledge of ICD-9, ICD-10, HCPC/CPT and other coding
• Proficient computer software; such as MS Word, Excel, and automated billing systems
• Able to use various type of office equipment; such as, facsimile machines, calculator, postage machine, copiers, etc.
• Knowledge of state, federal and regional collection and reimbursement laws
• Must have an enthusiastic and positive attitude
• Ability to work independently, exercise creativity, and be attentive to detail
• Proficiency with basic math and accounting skills
• Act with integrity in all ways and at all times, remaining honest, transparent, and respectful in all relationships.
• Keep the patient at the center of everything that you do, building lifelong trust.
• Foster open collaboration and constructive dialogue with everyone around you.
• Continuously innovate new solutions, influencing and responding to change.
• Focus on superior outcomes, and calibrate work processes for outstanding results.

Our Investment in You

• Competitive Compensation Packages
• 8 Paid National Holidays & 4 additional Floating Holidays
• PTO that includes Vacation and Sick time
• Medical, Dental, and Vision Benefits
• 401k Savings and Retirement Plan
• Paid Parental Bonding Leave for New Parents
• Flexible Work Schedules and Part-time Opportunities
• Generous Employee Referral Bonus Program
• Mentorship Programs- Mentor and Mentee
• Student Loan Repayment Assistance by Location
• Relocation Assistance
• Regional & National traveling CPO/CO/CP opportunities
• Volunteering for Local and National events such as Hanger’s BAKA Bootcamp and EmpowerFest

Hanger, Inc. is committed to providing equal employment opportunity in all aspects of the employer-employee relationship. All conditions and privileges of employment are administered to all employees without discrimination or harassment because of race, religious creed, color, age, sex, sexual orientation, gender identity, national origin, religion, marital status, medical condition, physical or mental disability, military service, pregnancy, childbirth and related medical conditions, special disabled veteran status, or any other classification protected by federal, state, and local laws and ordinances. The company will comply with all applicable state or local fair employment laws that forbid discrimination or harassment on the basis of other protected characteristics. Retaliation against any employee for filing or supporting a complaint of discrimination or harassment is prohibited.