Insurance Verification Coordinator (Specialty Benefit Verification)

CarepathRx; United States; Remote; USD 35,000 - 55,000; Full time

Job summary

A leading healthcare service provider is looking for an Insurance Verification Manager to oversee daily operations in insurance verification. This role involves verifying coverage, maintaining patient records, and ensuring the timely processing of insurance documents. Ideal candidates should have a high school diploma and relevant experience in a physician practice or healthcare setting, along with excellent communication and organizational skills.

Benefits

Medical, dental, and vision coverage

401(k) plan

Paid Time Off and paid holidays

Qualifications

• 1+ year of insurance verification or prior authorization in a healthcare setting required.
• Knowledge of medical terminology and payer websites preferred.
• Proficient computer skills required.

Responsibilities

• Verify insurance coverage and calculate costs.
• Enter and update patient demographics into the computer system.
• Assist with training new employees.

Skills

Excellent written and verbal communication

Organization

Time Management

Professional

Education

HS diploma or GED

Tools

Microsoft Office Products

Job description

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

Manage the daily functions of the Specialty Benefit Insurance Verification area including verification of insurance coverage, re-verifying coverage for existing patients, enter and update patient demographics into the computer system, and securing reimbursement related paperwork. Generate price/coverage quotes.

Responsibilities

• Work effectively and maintain expected productivity.

• Enter and update patient demographics into the computer system.

• Verify insurance coverage, calculate costs and document details in the patient profile.

• Generate a financial responsibility letter.

• Review benefits with patient via phone.

• Track, monitor and secure necessary insurance documents.

• Obtain prior authorizations as required.

• Coordinate completion of Financial Assistance forms, payment agreements and waivers.

• Assist with training new employees.

• Organize and prioritize tasks to be completed.

• Create new hospital and physician codes as needed.

• Give high priority to client satisfaction and customer needs.

• Cooperate with other staff members when planning and organizing reimbursement activities.

• Demonstrates the ability to work effectively and maintain expected productivity.

• Meets quality standards, shows pride in performance, and demonstrates reliability and follow-through on all assigned tasks.

• Assist with researching reimbursement issues.

• Performs in accordance with system-wide competencies/behaviors.

• Performs other duties as assigned.

Skills & Abilities

• Excellent written and verbal communication

• Organization

• Time Management

• Professional

Requirements

• HS diploma or GED required.

• 1+ year of insurance verification, prior authorization or other related experience in a physician practice, ancillary provider, or other relevant healthcare setting required.

• Knowledge of medical terminology required.

• Knowledge of payer websites, eligibility, coordination of benefits preferred.

• Knowledge of pharmacy vs medical payers and authorization preferred.

• Knowledge of plan formularies and authorization requirements preferred.

• Proficient computer skills and Microsoft Office Products required.

• Excellent math skills.

CarepathRx offers a comprehensive benefit package for full-time employees that includesmedical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits,401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire .

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.