Insurance Verification Coordinator I - 590069

Spectraforce Technologies, Inc.; Raleigh (NC); Remote; USD 34,000 - 48,000; Full time

Job summary

Spectraforce Technologies, Inc. is hiring a Insurance Verification Coordinator I for a remote, US-based assignment. The role focuses on obtaining and verifying insurance information, prior authorizations, and coordination of benefits for services provided.

The candidate should have 1+ year of medical billing or verification experience, strong customer service, and familiarity with payors and authorization processes. The assignment lasts 3 months with remote work.

Qualifications

• High school diploma required; 1+ year medical billing or insurance verification preferred.
• Bachelor's degree can substitute for experience.
• Strong customer service skills and familiarity with payors and prior authorization.

Responsibilities

• Obtain and verify insurance eligibility for services and document in system.
• Perform prior authorizations as required by payor source and coordinate with physicians' offices and insurers.
• Collect clinical information such as lab values and diagnosis codes.
• Determine patient's financial responsibilities as stated by insurance.
• Configure coordination of benefits information on referrals.
• Ensure assignment of benefits is obtained and on file for Medicare claims.
• Bill insurance companies for therapies provided.
• Document all communications with patient, physician, and insurer related to collection procedures.
• Identify and coordinate patient resources for reimbursement (copay cards, assistance programs).
• Handle inbound calls from patients, physician offices, and insurers.
• Resolve claim rejections for eligibility, coverage, and other issues.

Skills

Managed Care

Customer Service

Call Center

Education

High school diploma

Bachelor's degree substitution

Tools

Microsoft Office

Job description

Position Title: Insurance Verification Coordinator I

Work Location: Remote - US

Assignment Duration: 3 months

Work Schedule: Mon - Fri; Training schedule 9am-6pm EST for 6 weeks; Work schedule 12-9 EST

Work Arrangement: Remote

Position Summary

• Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits

Key Responsibilities

• Obtain and verify insurance eligibility for services provided and document complete information in system
• Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
• Collect any clinical information such as lab values, diagnosis codes, etc.
• Determine patient's financial responsibilities as stated by insurance
• Configure coordination of benefits information on every referral
• Ensure assignment of benefits are obtained and on file for Medicare claims
• Bill insurance companies for therapies provided
• Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
• Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
• Handle inbound calls from patients, physician offices, and/or insurance companies
• Resolve claim rejections for eligibility, coverage, and other issues

Qualification & Experience

• High school diploma with 1+ years of medical billing or insurance verification experience. Bachelor's degree in related field can substitute for experience. Experience with payors and prior authorization preferred. Strong customer service skills.
• Bachelor's degree in related field can substitute for experience. Experience with payors and prior authorization preferred. Strong customer service skills.

Candidate Requirements

• Education/Certification: Required: High school diploma
• Education/Certification: Preferred: NA
• Licensure: Required: NA
• Licensure: Preferred:
• Years of experience required: 1 + years of experience
• Disqualifiers: NA
• Additional qualities to look for: Proficient in Microsoft Office, experience/backgrounds that do well in this role- Managed Care, Pharmacy, Medical terminology, Physician office experience, Customer Service, Call Center

Top 3 must-have hard skills stack-ranked by importance

1. 1 Managed Care
2. 2 Customer Service
3. 3 Call Center