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)
The Insurance Verification Specialist will verify insurance eligibility and demographics through Electronic Medicaid Eligibility Verification System (EMEVS), Novitasphere, and NaviNet, as well as over the phone. Will be responsible for entering insurance information and updating demographic information in the electronic health record. Will create and upload statements on a monthly basis. Manage Medicare, Medicaid, and 3rd party claiming and accounts receivables as it relates to behavioral health services such as Outpatient, Case Management, Substance Abuse and Residential treatment. Will be responsible for reviewing claims in the electronic health record (Carelogic) for accuracy as well as submission of claims electronically through the Medicaid and ChangeHealthcare websites and via paper HCFA. Will monitor electronic claims to ensure successful transmission to clearinghouse. Must be able to understand and read the Explanation of Benefits (EOB).
Hours:
This is a full time position with the following benefits:
Education/Experience:
High School Diploma with computer experience required. Experience in electronic health records and insurance terminology preferred. Must be able to communicate clearly and pay attention to detail.
Must be able to work under required deadline schedules, while being flexible to special requests and projects. Must be able to professionally handle stressful situations.
Legacy Treatment Services is an Equal Opportunity Employer.
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