Insurance Verification & Billing Specialist

Helen Ross McNabb Center; Tennessee; On-site; USD 22,207 - 31,629; Full time

Job summary

The Helen Ross McNabb Center is seeking a Reimbursement Insurance Verification Specialist to obtain and verify client insurance coverage and ensure procedures are covered by insurance. You will enter data accurately in the billing system, verify client benefits, and resolve insurance issues.

Regular office hours at the designated facility are required. Responsibilities include reviewing forms, updating eligibility, supporting intake, and communicating with the Insurance Verification Team Leader

Qualifications

• Advanced use of computer system software, Excel, Outlook and Microsoft Word.
• Knowledge of insurance guidelines for Commercial, Medicare, TennCare, and private pay financial classes.
• Exceptional customer service skills for interacting with patients regarding medical claims and payments.
• Ability to work in a team environment and independently.
• Triaging priorities, delegating tasks if needed, handling conflicts, and resolving claims issues.
• Strong written and verbal communication skills.
• Maintain patient confidentiality per HIPAA.
• Understanding state, federal, and payer billing guidelines.
• Familiarity with center policies and procedures.
• Ability to work with upper leadership regarding claims issues and resolutions.

Responsibilities

• Reviews the center's Commercial Notification Forms and returns Insurance Verification Forms within program timeframes.
• Verifies insurance information is up to date for the next day's client roster and updates system pop-ups.
• For new clients, obtains client photo, updates EMR, and ensures intake paperwork is signed and verified.
• Prepares facesheets with insurance issues, patient responsibilities, balances, and non-payment changes.
• Analyzes eligibility reports daily.
• Communicates with Insurance Verification Team Leader about verification problems.
• Informs other departments of updated insurance information as needed.
• Adheres to policies and procedures for federal/state billing regulations.
• Communicates with billing representatives about insurance issues.
• Reviews and updates Non-Payment status documents for Med and Therapy appointments.
• Maintains a positive, professional attitude and timely email/voicemail responses.
• Collaborates with teams on process improvements.
• Possesses flexibility to work overtime as needed.
• Handles client benefit questions and ensures information is obtained for verification, billing, and claims follow-up.
• Collects balances and issues receipts.
• Assists in resolving insurance issues and determining action steps.
• Completes program paperwork for reporting purposes.
• Resolves discrepancies, denials, appeals, and collections.

Skills

Advanced computer system skills

Customer service

Teamwork

Prioritization/triage

Communication

HIPAA compliance

Insurance knowledge

Data entry accuracy

Problem solving

Education

High school diploma or equivalent

Tools

Excel

Outlook

Microsoft Word

Job description

The Helen Ross McNabb Center is seeking a Reimbursement Insurance Verification Specialist to obtain and verify client insurance coverage and ensure procedures are covered by insurance. You will enter data accurately in the billing system, verify client benefits, and resolve insurance issues.

Regular office hours at the designated facility are required. Responsibilities include reviewing forms, updating eligibility, supporting intake, and communicating with the Insurance Verification Team Leader