Insurance Specialist

Grand Island Clinic; Grand Island (NE); On-site; USD 36,000 - 52,000; Full time

Job summary

Grand Island Clinic seeks a Patient Insurance Specialist to manage patient insurance information, verify coverage, and facilitate communication between patients, the clinic, and payers. You will handle Good Faith Estimates, assist billing, and ensure HIPAA compliance across EMR systems.

The role requires meticulous data management, patient-facing communication, and the ability to resolve coverage issues efficiently. Proficiency with EMR systems like Allscripts and Phreesia is essential.

Qualifications

• High school diploma or equivalent required with 1 year of related experience preferred.
• Experience with Medicaid, Medicare and commercial insurance programs is preferred.
• Ability to verify insurance coverage and manage EMR data with attention to detail.

Responsibilities

• Greet patients and establish insurance records, verifying coverage prior to appointments.
• Update insurance information for existing patients across EMR systems.
• Obtain and upload identification documents (driver's licenses, insurance cards) to EMR.
• Verify coverage through electronic systems or payer contact to ensure timely reimbursement.
• Research denied claims and submit corrections to secure payment.
• Manage HIPAA forms and ensure proper storage of patient records.
• Explain statements and insurance coverage to patients and resolve inquiries.
• Set up payment plans or escalate to collections when necessary.

Skills

Insurance verification

HIPAA compliance

Communication

Data entry

Multitasking

Saturday availability

Education

High school diploma or equivalent

1 year experience in patient insurance verification/medical billing

Medicaid/Medicare/commercial insurance knowledge

Tools

Allscripts

Phreesia

Job description

Job Details: Job Location: Main Clinic - Grand Island, NE, Salary Range: Undisclosed, Job Summary:

As a Patient Insurance Specialist at Grand Island Clinic, you will play a key role in managing patient insurance information, ensuring accurate verification of coverage, and facilitating smooth communication between patients, the clinic, and third-party payers. This position involves collecting, updating, and verifying insurance details, addressing patient inquiries, managing Good Faith Estimates, and supporting billing operations by helping patients understand their coverage and resolving issues related to outstanding balances. The Specialist ensures that all patient insurance documentation complies with HIPAA and other regulatory requirements.

Essential Job Functions:

• Daily attendance: Ensure punctuality and consistent attendance during scheduled work hours, including Saturdays as required.
• Greet new patients and establish insurance records, verifying coverage prior to appointments.
• Update insurance information for existing patients, making changes as needed to ensure accuracy.
• Obtain and scan identification documents such as driver's licenses and insurance cards, uploading them to the Electronic Medical Record (EMR) system.
• Maintain current patient information in both Phreesia and Allscripts systems, ensuring data is accurate and up to date across platforms.
• Verify patient insurance coverage through electronic systems or direct contact with third-party payers, ensuring accurate information for timely reimbursement.
• Understand and stay knowledgeable about payer requirements, including Commercial, Medicaid, and Medicare programs, to assist with various patient insurance scenarios.
• Research denied claims and submit necessary corrections or additional information to resolve issues and secure payment.
• Monitor and manage HIPAA forms for new and existing patients, ensuring that completed forms are scanned, indexed, and stored in patient records.
• Answer patient inquiries regarding statements, balances, and insurance coverage, offering clear and helpful explanations.
• Contact patients regarding outstanding balances, working to set up payment arrangements, establish payment plans, or elevate accounts to collections when necessary.
• Communicate with front desk staff via Phreesia notes or Allscripts pop-up systems to ensure smooth coordination of patient care.
• Other duties as assigned.

Qualifications: Required Skills/Abilities:

• Strong understanding of insurance processes, including verification and claims resolution.
• Proficiency in using Electronic Medical Records (EMR) systems and other medical based software such as Allscripts and Phreesia.
• Excellent organizational skills and attention to detail to manage patient records and insurance verification accurately.
• Strong communication skills to interact with patients and internal staff professionally and clearly.
• Ability to resolve patient inquiries regarding insurance, balances, and statements in a compassionate and efficient manner.
• Problem-solving skills to research denied claims and make necessary corrections.
• Knowledge of HIPAA regulations and commitment to maintaining patient confidentiality.
• Ability to handle multiple tasks effectively in a fast-paced environment, including working on Saturdays as scheduled.

Education and Experience Requirements:

• High school diploma or equivalent required.
• Minimum of 1 year of experience in patient insurance verification, medical billing, or a similar healthcare administrative role; preferred.
• Experience with Medicaid, Medicare, and commercial insurance programs.
• Experience using EMR systems.

Physical Demands:

• Prolonged periods of sitting and working at a computer.
• Ability to focus on detailed tasks for extended periods.
• Occasional lifting of up to 15 pounds.
• Visual and auditory ability to communicate effectively with patients and staff via phone and computer systems.

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.

Grand Island Clinic is an equal-opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.