Central Insur Verification Rep

Orlando Health, Inc.; Melbourne (FL); On-site; USD 36,000 - 42,000; Full time

Job summary

Orlando Health, Inc. in Melbourne, FL seeks a Central Insurance Verification Rep to verify insurance plans for physicians, hospitals, and ambulatory centers. The role requires communicating with payers to confirm coverage and benefits and accurately inputting data for billing and referral processing.

You will work as part of a team, rotate on reports, and maintain regular attendance while meeting daily productivity goals in a full-time daytime role.

Qualifications

• High school diploma or equivalent.
• Onboarding to insurance verification processes and payer communications.
• Ability to work with multiple stakeholders to resolve coverage questions.

Responsibilities

• Verify insurance plan and network to ensure participation for physician offices, hospitals, or ambulatory centers.
• Contact payers to verify coverage and benefits and identify eligibility issues.
• Input insurance information accurately for billing and referrals.
• Coordinate benefits when needed and document alert notes on accounts.
• Maintain productivity and attendance in line with policies.

Skills

Insurance verification

Attention to detail

Communication

Teamwork

Education

High school diploma

Tools

Verification systems

Job description

Position Summary

Position: Central Insurance Verification Rep

Location: Melbourne, FL.

Shift: Full-time | Day shift

Summary: Work as part of a Team which is responsible for Insurance verification for the physician, hospital, or surgery appointments

Responsibilities

What you will do

• Verify insurance plan and network to make sure that the physician office, hospital, or ambulatory surgery center is participating.
• Contacts appropriate payers to verify insurance coverage and benefits.
• Knowledge in the use of understanding electronic verification tools and web based resources.
• Knowledge and familiar with a commercial and state funded insurance plans.
• Must be able to identify an HMO, POS, Open access and/or PPO type plan.
• Verify effective date, group number and claim address.
• Verify copays, deductible amounts, out of pocket amounts and co-insurance.
• Efficiently and accurately input the insurance information on the account for correct billing and proper referral processing.
• Reviews insurance coverage for same day appointments.
• Reviews and works reports for future appointments.
• Rotate with other staff to work reports and immediate attention forms.
• Link patient /guarantor party to the insurance on accounts.
• Communicate with the physician offices to report eligibility issues or obtain updated information to complete verification process.
• Identify and understand coordination of benefits when needed.
• Create alert notes on accounts with information that the offices will need to know.
• When insurance has an assigned PCP listed, note this on the accounts.
• Responsible to make insurance changes to all accounts when applicable.
• Notify Account Receivable to review accounts in question when making insurance changes.
• Must be able to keep up with the daily productivity goal for the department.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
• Maintains compliance with all Orlando Health policies and procedures.
• Work additional reports to research missing insurance on services that were rendered.
• Assist other team members if needed.
• Work on assigned projects.
• Attends and participates in department staff meetings as assigned.

Qualifications

• High school diploma or equivalent.
• No experience needed.