Verification Specialist

Mobile Medical Response; Saginaw (MI); On-site; USD 38,000 - 52,000; Full time

Job summary

Mobile Medical Response in Saginaw, MI is seeking an Entry Level Verification Specialist to accurately verify demographic and insurance information for emergency and non-emergency transports. The role focuses on billing verification, HIPAA compliance, and collaboration with office staff to obtain correct insurance details, authorization numbers, and patient demographics.

Strong computer skills and attention to detail are essential for daily pre-billing and data entry tasks.

Qualifications

• Medical office experience and familiarity with insurance billing practices preferred
• Obtain Emergency Medical Dispatcher (EMD) certification within first 6 months of employment
• Must proficiently use insurance websites i.e., C-Snap, Champs, Web Denis, etc., 2 months after date of hire
• Reading skills to comprehend correspondence and materials specific to the healthcare industry
• Must demonstrate ability to maintain security and confidentiality with utmost discretion
• Ability to communicate effectively both verbally and in writing, in the English language
• Ability to organize tasks and insure timely completion of all projects
• Advanced computer skills including the ability to utilize a computer PC with Windows operating system
• Ability to operate office equipment, including but not limited to, copier, fax machine, scanner, monitor, multi-line telephone, printer, typewriter and calculator
• Proficiency with Microsoft Word and Excel
• Regular attendance and timeliness
• Skilled in typing, data entry, scanning, electronic filing and document retrieval
• High School Diploma
• Must be at least 18 years old

Responsibilities

• Verify demographic and insurance information for emergency and non-emergency transports.
• Proficient with billing and prebilling insurances including Medicare, Medicaid, BCBS, and Commercial plans.
• Verify coverage through multiple systems and verify MMR membership.
• Utilize hospital websites to obtain insurance information.
• Verify coverage and auto insurance for claim/billing information over the phone.
• Obtain authorization number and record it prior to prebilling the claim.
• Contact patient for insurance information when correct information is not provided initially.
• Review PCS for proper signature, medical necessity, and completeness.
• Obtain repetitive PCS when needed 7 days prior to expiration.
• Verify all insurances related to the claim and correct patient demographics.
• Add CMS signature when obtained and required.
• Add signature information to Override Customer’s Signature area.
• Add both treating and referring physician under Tab 2 for non-emergency transports.
• Open and close calls and maintain HIPAA compliance.
• Membership entry and taxi billing; pre-bill all emergency and non-emergency claims.
• Perform other duties as assigned.

Skills

Insurance billing

Medical office experience

Data entry

Microsoft Word

Microsoft Excel

Communication skills

HIPAA compliance

English communication

Education

High School Diploma

Tools

Windows OS

Office equipment

Job description

Job Details

Level: Entry

Job Location: MMR State Street - Saginaw, MI 48603

Position Type: Full Time

Objective: The Verification Specialist accurately verifies demographic and insurance information for emergency and non-emergency transports.

Essential Duties

• Know and support the Mission Statement, Policy/Procedures and standards of MMR.
• Proficient with billing and prebilling the following insurances: Medicare, Medicaid, BCBS, and Commercial including auto hospice etc.
• Verify coverage through C-Snap, Web Denis, and Trizetto, and verify MMR membership.
• Utilize hospital websites to obtain insurance information.
• Verify coverage and auto insurance for claim/billing information over the phone, as necessary.
• Obtain authorization number and record the authorization number in the required field under Tab 3numbers, prior to prebilling the claim.
• Contact patient for insurance information when correct information is not initially provided.
• Review Physician’s Certification Statement (PCS) for proper signature, medical necessity, and completeness.
• Obtains repetitive Physician Certification Statement (PCS) when needed 7 days prior to the expiration of a current PCS.
• Proficiently verify all insurances that relate to the claim.
• Verify and correct patient demographic information.
• Add CMS signature when obtained.
• Add signature information to Tab 3 to “Override Customer’s Signature area.
• Add both treating and referring physician under Tab 2 for non-emergency transports.
• Open and close calls.
• Maintains HIPAA compliance.
• Membership entry.
• Taxi billing.
• Pre-bill all emergency and non-emergency claims.
• Perform other duties as assigned.

Knowledge, Skill and Competency Requirements

• Medical office experience and familiarity with insurance billing practices preferred
• Obtain Emergency Medical Dispatcher (EMD) certification within first 6 months of employment
• Must proficiently use insurance websites i.e., C-Snap, Champs, Web Denis, etc., 2 months after date of hire
• Reading skills to comprehend correspondence and materials specific to the healthcare industry
• Must demonstrate ability to maintain security and confidentiality with utmost discretion
• Ability to communicate effectively both verbally and in writing, in the English language
• Ability to organize tasks and insure timely completion of all projects
• Advanced computer skills including the ability to utilize a computer PC with Windows operating system
• Ability to operate office equipment, including but not limited to, copier, fax machine, scanner, monitor, multi-line telephone, printer, typewriter and calculator
• Proficiency with Microsoft Word and Excel
• Regular attendance and timeliness
• Skilled in typing, data entry, scanning, electronic filing and document retrieval
• High School Diploma
• Must be at least 18 years old

Physical Factors

Physical Factors: Suitable dexterity to operate standard office equipment. Capability to stand or sit for extended periods of time.

Working Conditions

Most work is done in a typical office setting with daily exposure in all other department areas. Regular, in-person attendance is an essential function of the job. Materials and equipment used include desktop computer, telephone, fax, copier, printer and other standard office equipment. Hours must be flexible to meet the demands of the office.