Insurance Change Specialist

VieMed Careers; Lafayette (LA); In loco; USD 32.000 - 48.000; Tempo pieno

Descrizione del lavoro

VieMed Careers seeks a detail-oriented Insurance Verification/Billing Clerk to support patient enrollment, verify coverage, and manage insurance claims within our DME/medical office environment in Lafayette, LA. You will collect demographics, determine benefits, and assist with authorizations as needed.

The role requires strong organization, proficiency in Microsoft Office, and clear communication with patients, doctors, and internal teams. Healthcare compliance knowledge is essential.

Competenze

• High school diploma or equivalent.
• Knowledge of patient database and billing systems.
• Verify insurance for all products.
• Understand insurance benefit breakdown of deductibles and co-ins.
• Understand Insurance medical and payment policies.
• Knowledge of Explanation of Benefits from insurers.
• General knowledge of Medicare & Medicaid regulations.
• Working knowledge of CPT/ICD-10, HCFA 1500, UB04, HIPAA, and billing rules.

Mansioni

• Obtain patient demographic and health insurance information and collect co-pays when appropriate.
• Verify and record insurance benefits and provide insurance breakdowns.
• Obtain prior authorization when required by payer(s) and follow up daily.
• Read and interpret medical documentation accurately.
• Resolve front collections accounts and document in the system.
• Maintain communication with patients, families, physicians’ offices and internal teams for patient benefit.
• Perform clerical tasks such as answering calls, faxing and emailing.
• Escalate concerns to Revenue Cycle Manager and Supervisor.
• Contribute to other assigned projects.

Conoscenze

Professional communication

Organizational skills

Attention to detail

Formazione

High School Diploma or equivalent

Strumenti

Microsoft Office

Outlook

Word

Excel

Descrizione del lavoro

• Obtains patient demographic and health insurance information; collects co-pay(s) when appropriate.
• Verifies and records insurance benefits with the ability to understand and provide insurance breakdowns.
• If required by payer(s), obtains prior authorization &/or follows up on authorization daily.
• Able to read through and understand medical documentation effectively
• Resolves Front Collections accounts as well as documenting within computer system appropriately.
• Establishes and maintains effective communication and good working relationships with patients/family, physicians’ offices, and other internal teams for the patient’s benefit.
• Performs other clerical tasks as needed, such as
  • Answering patient/Insurance calls
  • Faxing and Emails
• Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Revenue Cycle Manager and Supervisor
• Other responsibilities and projects as assigned.

Requirements

• High School Diploma or equivalent.
• Learns and maintains knowledge of current patient database and billing system
• Verifying Insurance for all products
• Understand Insurance benefit breakdown of deductibles and co-ins
• Understand Insurance Medical and Payment Policies
• Knowledge of Explanation of Benefits from insurance companies
• General knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid
• Working knowledge of CPT and ICD-10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
• Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.
• Utilizes initiative while maintaining set levels of productivity with consistent accuracy.

Experience

• 2-4 Years in DME or Medical Office experience preferred.
• Minimum of 1 year of insurance verification or authorizations required.

Skills

• Superior organizational skills.
• Proficient in Microsoft Office, including Outlook, Word, and Excel.
• Attention to detail and accuracy.
• Effective/professional communication skills (written and oral)

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

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