Insurance Eligibility Verification Specialist

San Antonio Wings, Inc; Enid (OK); In loco; USD 36.000 - 48.000; Tempo pieno

Descrizione del lavoro

San Antonio Wings, Inc. is seeking an Insurance Eligibility Verification Specialist to verify patient insurance coverage prior to scheduled medical services and ensure accurate eligibility and benefits information is obtained and communicated to staff and patients.

The role supports efficient billing and reimbursement processes and may involve locating and correcting insurance issues to maximize revenue. The specialist will enter data into the EMR, communicate with patients to obtain missing

Competenze

• High school diploma or equivalent required.
• Proficiency in data entry, Excel, word processing, ten-key calculator and typing required.
• Ability to organize, communicate and perform detailed functions required.

Mansioni

• Verify patient insurance eligibility and benefits for upcoming appointments using payor portals or by contacting insurance carriers.
• Confirm coverage details including copay, deductible, coinsurance, and coverage limitations.
• Enter accurate insurance and eligibility information into the EMR.
• Contact patients to obtain missing insurance information.
• Train PAS on insurance eligibility.
• Identify and resolve insurance eligibility discrepancies prior to the patient visit if possible.
• Prepare ad hoc projects for management, as necessary.
• Maintain strict confidentiality; adhere to all HIPAA guidelines/regulations.
• Document verification results and maintain detailed records for billing and audit purposes.

Conoscenze

Data entry

Excel

Typing

Ten-key calculator

Communication

Detail-oriented

HIPAA knowledge

Formazione

High school diploma or equivalent

Descrizione del lavoro

The Insurance Eligibility Verification Specialist works in cooperation with the Billing Manager and CFO to manage Insurance Eligibility Verification. This role verifies patient insurance coverage prior to scheduled medical services, ensuring accurate eligibility and benefits information is obtained, documented, and communicated to staff and patients to support efficient billing and reimbursement processes. The specialist will correct claims with insurance issues and ensure they are rebilled in a timely manner to maximize revenue. This position requires attention to detail and the ability to work under firm deadlines.

Responsibilities

• Verify patient insurance eligibility and benefits for upcoming appointments using payor portals or by contacting insurance carriers.
• Confirm coverage details including copay, deductible, coinsurance, and coverage limitations.
• Enter accurate insurance and eligibility information into the EMR.
• Contact patients to obtain missing insurance information.
• Train PAS on insurance eligibility.
• Identify and resolve insurance eligibility discrepancies prior to the patient visit if possible.
• Prepare ad hoc projects for management, as necessary.
• Maintain strict confidentiality; adhere to all HIPAA guidelines/regulations.
• Document verification results and maintain detailed records for billing and audit purposes.

Qualifications

• High school diploma or equivalent required.
• Proficiency in data entry, Excel, word processing, ten-key calculator and typing required.
• Ability to organize, communicate and perform detailed functions required.
• Preferred: Insurance knowledge preferred.
• Some traveling to other sites may be required.