Insurance Verification Coordinator- Advanced Orthopaedics & Sports Medicine

Paycom; Houston (TX); On-site; USD 38,000 - 52,000; Full time

Job summary

Paycom is seeking an Insurance Verification Coordinator in Houston, TX to verify patient insurance, determine eligibility, and communicate with providers to resolve discrepancies. This role supports clinicians and staff to ensure timely service and reimbursements.

Ideal candidates have a high school diploma, healthcare or insurance experience, familiarity with EMR systems, and strong attention to detail. Spanish language skills are a plus.

Qualifications

• High school diploma or equivalent required.
• Previous experience in a healthcare or insurance-related role preferred.
• Familiarity with medical terminology and insurance coding.
• Strong attention to detail and accuracy in data entry.
• Associate degree in healthcare administration or related field preferred.
• Spanish language ability is beneficial.

Responsibilities

• Complete all office visit/surgery verification and precertification to support timely care and patient satisfaction.
• Provide surgical/injectable estimates to patients.
• Contact insurance companies for authorization/precertification; deliver records to expedite processing and verify eligibility and benefits.
• Document verification status and patient financial responsibility in the system.
• Collaborate with supervisors and staff; cross-train and cover responsibilities as needed.
• Assist administration with projects and audits as required.

Skills

Attention to detail

Healthcare/insurance experience

EMR systems

Typing

Spanish language

Education

High school diploma or equivalent

Associate degree in healthcare administration or related field

Tools

EMR systems

Job description

The Insurance Verification Coordinator plays a crucial role in ensuring that patients receive the necessary insurance coverage for their medical services. This position involves verifying patient insurance information, determining eligibility, and communicating with insurance providers to resolve any discrepancies. The coordinator will work closely with healthcare providers and administrative staff to facilitate a smooth patient experience and minimize delay in service. By accurately processing insurance verifications, the coordinator helps to ensure that the organization receives timely reimbursements for services rendered. Ultimately, this role contributes to the overall efficiency and effectiveness of the healthcare delivery system.Key Responsibilities:Complete all office visit/surgery verification, authorization/precertification to improve customer satisfaction allowing no more than 2 weeks.Completes and provides surgical/injectable estimates to patients.Contacts insurance company for authorization/precertification requirement, initiate request and deliver pertinent medical records, i.e., chart notes, diagnostic imaging reports, and op notes, to expedite process; obtains patient eligibility and benefits via phone (live/automated) or online portal.Notates pertinent information in the system regarding patient insurance verification/pre-certification status and patient financial responsibility.Conducts self a positive role model and team memberRecognizes patients’ rights and responsibilities and supports them in performance of job dutiesPerforms according to established compliance policies and proceduresSeeks new learning experiences by accepting challenging opportunities and responsibilitiesActs as liaison with the supervisor to ensure verification, precertification needs are met. (i.e. verifier having difficulty obtaining benefits, precertification coordinator having difficulty obtaining pre-cert, etc.)Assists the administrator and/or supervisor with various administrative projects as directed. (i.e., auditing rejected claims etc.)Works with the supervisor to ensure cross-training of all staff and reassign (in the absence of the supervisor) responsibilities for coverage when a staff member is out.Assists supervisor in training staffs who are failing to perform according to the department/organizational standard.Any additional duties as assignedRequired Skills & Competencies:High school diploma or equivalentPrevious experience in a healthcare or insurance-related roleStrong attention to detail and accuracy in data entryAssociate degree in healthcare administration or a related fieldFamiliarity with medical terminology and insurance codingExperience with electronic medical record (EMR) systemsLanguage Ability: Able to read and comprehend simple instructions, short correspondence or memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients and other employees of the organization. Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar. Ability to speak and communicate in Spanish is beneficial.Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.Computer Skills: Basic computer skills and operational knowledge are required. Good typing skillsCertificates and Licenses: None required.Personal Skills: Insurance Verifier must have a pleasant and efficient manner in person and over the phone. Accuracy and attention to detail is essential to the job. The ability to work well under pressure and an awareness and understanding of other cultures are also important. Needs to have reasonable planning and organization skills as well as multi-tasking and prioritization abilities