Insurance Verification Specialist

Valora Medical Group; Irving (TX); On-site; USD 42,000 - 62,000; Full time

Job summary

Valora Medical Group in Irving, TX is seeking an Insurance Verification Specialist to ensure accurate patient accounts and timely claim processing.

You will contact insurance carriers, post payments, and work denials and aging reports while providing courteous, professional service. Bilingual English/Spanish is a plus.

Requires high school diploma, 1 year with EMR eCW, and knowledge of ICD-10/CPT; Excel skills and strong communication are preferred.

Qualifications

• High School Diploma or equivalent required.
• Bilingual in English and Spanish is highly preferred.
• Primary Care billing experience is required.
• 1 year experience with EMR System eCW is required.
• Knowledge of ICD-10 and CPT coding preferred.
• Excel proficiency and strong communication skills are plus.

Responsibilities

• Work outstanding claims, denials, appeals, and aging reports to determine follow-up actions.
• Answer billing-related calls and questions.
• Collect information to prepare claims accurately before patients are billed.
• Ensure ICD-10 and CPT codes on claims are correct for billing.
• Schedule and complete follow-ups with patients and insurance carriers promptly.
• Notate calls, resubmissions, adjustments, and collections per policy.

Skills

Bilingual English/Spanish

Billing experience

Excel

Communication

Interpersonal skills

Adaptability

Analytical skills

Attention to detail

Education

High School Diploma

Tools

eClinical Works (eCW)

Job description

Position:Insurance Verification Specialist

Location: Irving, TX

Job Id:281

# of Openings:1

Valora Medical Group is a visionary company focused on high-quality primary care and value-based care and, consists of healthcare providers and professionals dedicated to the health and well-being of our patients. At Valora, we treat our patients like family.

With multiple locations throughout the Dallas-Fort Worth area and our new expansion to central Florida, we understand that providing quality medical care and an exceptional patient experience requires having an outstanding team.

**Bilingual in English and Spanish is a plus**

Job Summary:

The Billing/Insurance Verification Representative is responsible for ensuring all patient account and claim information is accurate, that changes to patient information and claims are processed accurately and timely, and ensures that all patient interactions are courteous, compassionate, and professional.

Essential Duties and Responsibilities:

• Work outstanding claims, denials, appeals, and aging reports to determine the appropriate follow-up action.
• Answering Calls with billing questions
• Collect all information necessary to prepare claims accurately before patients are billed.
• Ensure the correct ICD-10 and CPT codes on claims are accurate for billing purposes.
• Ensure all scheduled follow-ups with patients and insurance carriers are completed in a timely manner.
• Review and interpret EOB denial and remark codes.
• Meet individual and department goals set forth by management.
• Notate all calls, resubmissions, adjustments, and collections in accordance with departmental policies and procedures.
• Communicate with patients regarding delinquent accounts.
• Ensure all necessary documentation and information is correct according to departmental policies and procedures
• Post payments, including both patient and insurance payments.
• Additional duties as assigned by management.

Education/Qualifications:

• High School Diploma or equivalent required
• Bilingual in English and Spanish is highly preferred
• Primary Care billing experience is required
• Minimum of 1 year experience with EMR System E-Clinical Works (eCW) is required
• Knowledge of medical and billing terminology, including ICD-10 and CPT coding is preferred
• Intermediate experience with Microsoft Office, specifically Excel
• Must have effective written, verbal communication, and interpersonal skills
• Ability to remain professional at all times
• Demonstrates the ability to explain complex information to others
• Ability to establish working relationships, resolve interpersonal conflicts, and apply basic staff etiquette in dealing with others
• Ability to handle confidential information with discretion
• Strong analytical skills with attention to detail
• Ability to learn new procedures and adapt quickly to change
• Ability to multitask and handle a variety of priorities
• Innovative, motivated, organized, and team player
• Proactive and self-starter
• Follow through with commitments

EEO Statement:

Valora Medical Group, LLC is an equal opportunity employer and does not discriminate on the basis of race, color, religion, creed, sex, national origin, age, disability, pregnancy status, sexual orientation, gender identity, veteran status, marital status, genetic information, citizenship status, or other status protected by law. In compliance with the Immigration Reform and Control Act of 1986, we will hire only U.S. citizens and aliens lawfully authorized to work in the United States.