Insurance Eligibility & Verification Pro

ADP, Inc.; Winter Haven (FL); Vor Ort; USD 25.000 - 34.000; Vollzeit

Benefits dieser Stelle

401(k)

401(k) Matching

Health Insurance

Paid Time Off

Paid Training

Professional Development Assistance

Referral Program

Zusammenfassung

Eye Specialists of Mid‑Florida P.A. is seeking an Insurance Verification/Eligibility Specialist to ensure accurate patient insurance data prior to services.

The role supports revenue cycle by confirming coverage, benefits, and authorizations through payer portals, calls, and electronic systems. Key duties include verifying eligibility, updating records, obtaining information, and communicating findings to patients and internal teams.

Qualifikationen

• High School Diploma or equivalent required.
• 1 year insurance verification experience preferred.
• 1 year medical billing or revenue cycle experience preferred.
• Experience with insurance payer websites and electronic verification systems preferred.
• Knowledge of commercial and government insurance plans preferred.
• Ophthalmology or other specialty healthcare experience preferred.

Aufgaben

• Verify patient eligibility, insurance coverage, benefits, effective dates, deductibles, copayments, coinsurance, limitations, exclusions, and other applicable payer requirements.
• Confirm the accuracy of patient demographic and insurance information and update systems as necessary.
• Obtain and document insurance information using payer websites, electronic systems, telephone calls, and other approved resources.
• Identify inactive coverage, discrepancies, missing information, coordination of benefits issues, and other insurance-related concerns and communicate them to the appropriate department for resolution.
• Review insurance requirements for referrals, authorizations, precertifications, and other payer-specific requirements.
• Enter and maintain accurate insurance and patient information in applicable systems and databases.
• Process insurance verification requests and address verification rejections or discrepancies in a timely manner.
• Review and maintain documentation in accordance with departmental procedures and payer requirements.
• Research payer policies, benefits, and coverage requirements as needed to support accurate patient and insurance information.
• Communicate insurance verification findings clearly and professionally to patients, providers, and internal departments as appropriate.
• Work closely with Scheduling, Patient Care, Billing, and other departments to ensure insurance information is accurate and available for timely claims processing.
• Assist in identifying and resolving insurance-related issues that may delay billing, claims submission, reimbursement, or collection.
• Maintain accurate and organized records of insurance verification activities and related documentation.
• Protect the confidentiality and security of patient, insurance, financial, and business information in accordance with HIPAA and ESMF policies and procedures.
• Assist management with the development and improvement of departmental procedures by providing feedback and information related to insurance verification processes.
• Maintain knowledge of payer requirements, insurance policies, and changes that may affect eligibility, benefits, verification, and reimbursement.
• Meet established departmental productivity, quality, accuracy, and turnaround-time expectations.
• Perform other duties and responsibilities as assigned by management.

Kenntnisse

Insurance verification

Attention to detail

HIPAA awareness

Communication skills

Data entry

Confidentiality

Ausbildung

High School Diploma

1 year insurance verification experience

1 year medical billing experience

Experience in medical office/ revenue cycle

Payer websites / verification systems experience

Jobbeschreibung

Eye Specialists of Mid‑Florida P.A. is seeking an Insurance Verification/Eligibility Specialist to ensure accurate patient insurance data prior to services.

The role supports revenue cycle by confirming coverage, benefits, and authorizations through payer portals, calls, and electronic systems. Key duties include verifying eligibility, updating records, obtaining information, and communicating findings to patients and internal teams.