Insurance Verification Specialist

Synergy Health Partners MSO, LLC; Troy (MI); On-site; USD 38,000 - 52,000; Full time

Job summary

Synergy Health Partners is seeking a Verification Specialist to support procedure scheduling by collecting patient demographics and insurance information, then entering data into the EHR/EPM for insurer authorizations. The role includes verifying insurance for patients and coordinating payment assistance when needed, within a busy office environment in Troy, MI.

The position emphasizes accuracy, communication, and compliance with third-party payor rules, with duties across eligibility checks,

Qualifications

• High School Diploma or GED required.
• Minimum 2 years medical billing office experience or equivalent with medical payors.

Responsibilities

• Obtain prior authorization and eligibility verification from insurance for visits, procedures, and MRIs.
• Investigate and interpret insurance information and communicate changes to relevant staff.
• Verify Auto and WC insurance with carriers and ensure legal representation status.

Skills

Data accuracy

Communication

Keyboard skills

Medical terminology

Billing rules

Payor experience

Education

High School Diploma or GED

Job description

General Summary The Verification Specialist is responsible for participating in procedure scheduling activities by collecting patient demographic and insurance information, processing and entering that data into the practice EHR/EPM for work with insurers in obtaining prior authorizations. The Verification Specialist verifies insurance for all patients and other prospective clients as well as confirming insurers' guidelines are met prior to scheduling appointments and procedures. The Verification Specialist also coordinates requests for application of payment assistance.

Job Description

Job Description

General Summary

The Verification Specialist is responsible for participating in procedure scheduling activities by collecting patient demographic and insurance information, processing and entering that data into the practice EHR/EPM for work with insurers in obtaining prior authorizations. The Verification Specialist verifies insurance for all patients and other prospective clients as well as confirming insurers' guidelines are met prior to scheduling appointments and procedures. The Verification Specialist also coordinates requests for application of payment assistance.

Job Duties

• Obtain prior authorization and verification of eligibility from insurance carrier for office visits, procedures, and MRI’s.
• Investigate and interprets all incoming insurance information regarding patient benefits or processing changes and communicates these to appropriate personnel following department protocol.
• Verify Auto and WC insurance with the insurance carrier and verify legal representation with the attorney's firm.
• Obtain co-pay and deductible information and accurately records this information into the EHR and practice management system.
• After obtaining verification of benefits, inform patient of high deductibles and/or prepayment for upcoming surgery or procedure, to be collected prior to or on day of service
• Effectively utilize automated tools. (Web Denis, C Snap)
• Coordinates insurance referral process with patient following department needs
• Performs referral check and makes the appropriate notes in practice management system.
• Handles phone inquiries from patients, payors, medical office, and or testing facility regarding authorization, benefits, or verification.
• Other duties as necessary and/or assigned.

Minimum Qualifications

• Required Certifications, Registration or Licensure: None
• Minimum Knowledge and Education: High School Diploma or GED
• Minimum Work Experience: Minimum 2 years medical billing office experience or equivalent experience with medical payors

Specific Knowledge, Skills, Abilities

• Extreme accuracy in data analysis and reproduction
• Good communication and interpersonal skills
• Keyboard skills
• Medical terminology
• Knowledge of third-party billing rules
• Experience working with third-party payors

Working Conditions

• Works in a normal busy office environment.

Company Description

Synergy Health Partners is a healthcare management organization at the forefront of patient care. We work with our physicians, nurses, and other clinical staff to maintain the highest quality of care centered on patient-focused outcomes. With respect for the person and their health as the driving mindset behind our practice, we aim to provide cutting-edge compassionate treatment to each and every one of our patients. We partner with healthcare practices large and small and use over forty years of experience in medicine in the Metro Detroit area to ensure peace of mind to all of those in our care.

Synergy Health Partners is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Synergy Health Partners is a healthcare management organization at the forefront of patient care. We work with our physicians, nurses, and other clinical staff to maintain the highest quality of care centered on patient-focused outcomes. With respect for the person and their health as the driving mindset behind our practice, we aim to provide cutting-edge compassionate treatment to each and every one of our patients. We partner with healthcare practices large and small and use over forty years of experience in medicine in the Metro Detroit area to ensure peace of mind to all of those in our care. Synergy Health Partners is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.