Insurance Verification & Authorization Agent

OPTIMUS Health Care; Stratford (CT); On-site; USD 21,000 - 24,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Retirement benefits

Paid time off and holidays

Job summary

Optimus Health Care Inc. in Stratford, CT is seeking a Full Time Insurance Verification & Authorization Specialist to join our BH care team. The role ensures a complete and timely insurance and authorization flow, contacting insurers and walking patients through their benefits.

Flexibility to work at other Optimus locations is a plus. The position emphasizes verification of insurances for billing, coordination of benefits, and collaboration with Providers, Nurses, and Clinical Support staff to

Qualifications

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

Responsibilities

• Verify 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 online verification including amounts met to date and any pre-authorization requirements.
• Verify coordination of benefits using the birthday rule if patient is a minor.
• Update patient notes in the system with pertinent insurance changes or concerns to ensure account history is available for departments.
• Assist the Practice Manager with related special projects, including billing participation in performance improvement initiatives.
• Refer entitlement cases to FCC as applicable.
• Communicate with patients regarding insurance coverage concerns and any information required by the carrier to process payment.
• Perform other related duties as required.

Skills

Insurance verification

Authorization processes

Billing support

Tools

EMR familiarity

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

Billing Full Time Clerical Stratford, CT, US

Salary Range: $21.00 To $24.00 Annually

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 aFull Time Insurance Verification & Authorization Specialistto join our team inStratford, CT location.

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.

Compensation decisions are made in accordance with applicable federal and Connecticut equal-pay requirements. The final offer will be determined based on job-related factors, including relevant experience, education, specialized skills, scope of responsibilities, market conditions, and internal equity. The salary range does not guarantee placement at any specific point within the range. Eligible employees may receive employer-sponsored benefits, covering medical, dental, and vision coverage; retirement benefits; paid time off and holidays; and other employer-sponsored benefits, subject to plan terms and eligibility.

Optimus is committed to providing equal employment opportunities to all

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