Cardiology Insurance Verifier: Impactful, Fast-Paced Role

DHR Health; McAllen (TX); Hybrid; USD 36,000 - 48,000; Full time

Job summary

DHR Health in McAllen, TX seeks an Insurance Verifier for the Cardiology Group Shared to determine insurance eligibility and patient financial status. You will verify benefits with payers, review coverage dates, and identify authorization needs daily.

Ideal candidates have 2+ years in insurance verification, strong medical terminology knowledge, and excellent communication skills. Proficiency with TMHP/Availity is a plus; bilingual ability is preferred.

Qualifications

• High school diploma or GED required.
• Comprehensive understanding of insurance benefits, referral requirements, reimbursement and medical terminology.
• Ability to work with geriatric patients in a high-volume fast-paced practice.
• Computer skills with Microsoft Office and internet.
• Excellent written and verbal communication skills; bilingual English/Spanish preferred.

Responsibilities

• Serve as a daily resource for questions from providers, management and staff.
• Monitor and verify benefits on accounts requiring referrals and authorizations daily.
• Assist billing staff with researching accounts with discrepancies to ensure appropriate payer reimbursement.
• Handle calls from patients, physicians, carriers and providers regarding referrals and authorizations.
• Confirm billing address and in/out of network benefits and maximum coverage for services.
• Reference ICD-9-CM/ICD-10-CM, CPT codes from doctor’s order to insurance carrier.

Skills

Insurance verification

Bilingual English/Spanish

Communication skills

Medical terminology

Microsoft Office

Education

High School Diploma/ GED

Tools

TMHP

Availity

Customer Kiosk

Job description

DHR Health in McAllen, TX seeks an Insurance Verifier for the Cardiology Group Shared to determine insurance eligibility and patient financial status. You will verify benefits with payers, review coverage dates, and identify authorization needs daily.

Ideal candidates have 2+ years in insurance verification, strong medical terminology knowledge, and excellent communication skills. Proficiency with TMHP/Availity is a plus; bilingual ability is preferred.