Insurance Verification Specialist

Triton Medical Solutions; Mesa (AZ); Remote; USD 40,000 - 70,000; Full time

Job summary

An innovative medical billing company is seeking a detail-oriented Insurance Verification Specialist to join their remote team. This role is crucial in ensuring that patients receive the maximum coverage for their medical services. As a key player, you will verify insurance benefits, communicate with providers, and manage documentation with precision. If you have a positive attitude and thrive in a fast-paced environment, this opportunity is perfect for you. Join a supportive team that values confidentiality and accuracy, and make a meaningful impact in the healthcare industry while enjoying the flexibility of working from home.

Benefits

Flexible schedule

Qualifications

• General knowledge of medical insurance terminology and coding required.
• Experience with medical billing and verifying benefits is essential.

Responsibilities

• Verify patients' medical plan benefits and ensure coverage.
• Handle communications with insurance payers and update patient information.

Skills

Medical billing experience

Attention to detail

Excellent communication skills

Interpersonal skills

Ability to multi-task

Research skills

Tools

Certified medical billing software

Microsoft Office

Job description

Benefits:

Flexible schedule

Job Summary: Medical billing company located in Tempe, Arizona is seeking a Remote/Work from Home Insurance Verification Specialist for 20-35 hours per week. This position is a 1099 position. As a critical member of our team, demeanor, and confidentiality is a crucial aspect of this position. This person will be an important member of our team and must be willing to perform a specific set of skills.

We are looking for a fun, positive person who is detail oriented and can multi-task with great energy. Previous medical billing experience and experience with a certified medical billing software is required.

Essential Functions:

1. Verify patients' medical plan benefits and requirements according to their specific medical policy, to ensure necessary procedures are covered by an individual’s provider and maximum payment for services rendered.
2. Handle incoming and outgoing communications from internal team members, insurance payers, and customers related to insurance benefits.
3. Identify important patient and demographic information that are missing and update information to avoid claim processing issues with the insurer.
4. Determine if prior authorization and/or gap exception is required for ordered services.
5. Ensure appropriate clinical documentation is available and complete before submitting the prior authorization and/or gap exception.
6. Send clinical documentation to the insurance company for review and approval.
7. Follow up with insurance companies to ensure documentation has been received and prior authorization and/or gap exception is in process.
8. Obtain and review prior authorization and/or gap exception approval and upload approval documentation to the patient’s chart.
9. Communicate to our providers that the approval is complete through a ticket application.
10. Ensure security and confidentiality of data and office technology.

Qualifications:

1. General knowledge of insurance cards, medical insurance terminology, medical benefits, and CPT and ICD 9/10 coding required.
2. Microsoft Office experience required.
3. Previous experience with a medical billing company in verifying benefits and/or pre-authorizations.
4. Previous experience with certified medical billing software.
5. Excellent communication and interpersonal skills.
6. Attention to accuracy and detail in all aspects of responsibilities.
7. The ability to manage priorities and focus on completing tasks efficiently and within time frames.
8. Experience performing research utilizing the Internet.
9. Excellent organizational skills.
10. Updated computer system including but not limited to high-speed internet, Microsoft 360, 2 or more monitors, and willingness to have your computer system encrypted to maintain HIPAA compliance.

This is a remote position.