Insurance Verification & Authorization Agent

Optimus Health Care Inc.; Stamford, Northern (CT, KY); Hybrid; USD 28,000 - 39,000; Part time

Job summary

Optimus Health Care Inc. in Stamford, CT, is seeking a Part-Time Insurance Verification & Authorization Specialist to join the Behavioral Health department. This role focuses on verifying insurance coverage, obtaining approvals, and guiding patients through their benefits to ensure timely access to services.

You’ll work with Providers, Nurses and staff to verify demographics, coordinate benefits, update notes, and refer entitlements as needed, with the flexibility to cover other sites.

Qualifications

• Five years experience preferred, preferably in a health care setting.
• Familiarity with EMR is helpful.
• Commitment to maintaining patient privacy.
• Flexibility to work at other Optimus Health Care sites.

Responsibilities

• Verify insurances to ensure billing of services.
• Verify coverage, copays and deductibles and pre-authorization requirements.
• Coordinate benefits using the birthday rule for minors when applicable.
• Update patient notes with insurance changes for department history.
• Assist the Practice Manager with special projects including billing improvement initiatives.
• Refer entitlement cases to FCC when patient qualifies.
• Communicate with patients about coverage and any information required by carriers.
• Perform other related duties as required.

Skills

Insurance verification

Authorization processing

EMR familiarity

Patient communication

Tools

EMR system

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Insurance Verification & Authorization Agent

Stamford, CT, US

5 days ago Requisition ID: 1627

Join a Team That Makes a Difference at Optimus Health Care!

Are you passionate about providing high-quality, patient-centered care? Optimus Health Care—the largest provider of primary health care services in Fairfield County is looking for dedicated professionals to join our team! With multiple locations in Bridgeport, Stratford, and Stamford, our mission is to be a lifelong health care partner, dedicated to achieving optimal wellness for the communities we serve.

Optimus Healthcare is looking for a Part-Time Insurance Verification & Authorization Specialist to join our Behavioral Health department in Stamford, CT location (covering other sites as needed).

The Insurance Verification & Authorization Agent is a member of our BH care team responsible for working with Providers, Nurses, and Clinical Support staff to ensure a complete and timely insurance and authorization flow process. Assure that pre-work is performed before the patient arrives by verifying demographic and insurance information to ensure prompt payment of services to Optimus. This position will contact patient’s insurance company to verify coverage levels and works with patients to walk them through their benefits information. The position works to ensure that patients have been authorized for specialty services and office visits. May act as a liaison between the patient, provider/referring provider, BH provider, and other parties involved in the plan of care. Appropriately link referrals for identified visits.

Essential Functions & Responsibilities:

Responsible and accountable for verification of insurances to ensure billing of services.

• Review appointment schedules to identify insurance for verification, with particular insurance plans.
• Verify insurance coverage, copays and deductibles through employer, insurance carrier, and/or on line verification including the amounts “met to date” and any pre-authorization requirements.
• Verify coordinate of benefits in using the “birthday rule”, if patient is a minor.
• Update patient notes in the system with pertinent insurance changes or concerns, as a means to ensure account history is available for respective departments.
• Works closely and assists the Practice Manager with related special projects as necessary, including billing participation in performance improvement initiatives
• If patient qualifies for entitlement refer (by task) to FCC.
• Responsible to communicate with patient on insurance coverage concerns and any additional information required by carrier to process payment.
• Perform other related duties as required.

Additional General Requirements:

Familiarity with EMR, helpful.

Commitment to maintenance of patient privacy

Flexibility to work at other OHC sites as necessary.

Job Qualifications/Requirements:

Experience: five years experience preferred, preferably in a health care setting.

Optimus is committed to providing equal employment opportunities to all

applicants and employees as protected by applicable federal and/or state law.