Healthcare Insurance Verification & Authorization Specialist

Baystate Health; Springfield (MA); On-site; USD 27,000 - 36,000; Full time

Job summary

Baystate Health in Springfield, MA is seeking an Insurance Verification Specialist to verify patient insurance information and benefits, obtain authorizations, and help secure admissions. This role involves collaborating with care teams to reduce bad debt and maximize reimbursement.

The position requires attention to payer rules and accurate documentation. The ideal candidate has medical billing or authorization experience and strong proficiency with Microsoft Office.

Qualifications

• Medical billing and/or Authorization and Referral focus.
• Healthcare accounts receivable experience preferred.
• Strong Microsoft Office skills.

Responsibilities

• Secures accounts to obtain proper reimbursement and verifies eligibility and benefits for assigned accounts.
• Obtains certifications/authorizations and identifies gaps in coverage with providers and care teams to minimize self-pay balances.
• Follows up with payers to resolve coverage/benefit issues and documents account activity.
• Collaborates with Case Management, Denials Management, and Patient Accounting to recover payment for denials.
• Maintains knowledge of payer guidelines through web portals and carrier communications.
• Independently resolves insurance authorization and assignment issues.
• Participates in cross training for efficient, customer-friendly service and meets productivity standards.
• Maintains account accuracy average rate of ≥97%.
• Demonstrates proficient use of necessary computer programs.

Skills

Microsoft Office Suite

Job description

Baystate Health in Springfield, MA is seeking an Insurance Verification Specialist to verify patient insurance information and benefits, obtain authorizations, and help secure admissions. This role involves collaborating with care teams to reduce bad debt and maximize reimbursement.

The position requires attention to payer rules and accurate documentation. The ideal candidate has medical billing or authorization experience and strong proficiency with Microsoft Office.