Description
Position Summary: We are seeking a detail-oriented and experienced Eligibility Insurance Verification Specialist and Referral Coordinator to join our team. The ideal candidate will have 2-5 years of experience in insurance verification and referral coordination within a healthcare setting. This role is critical in ensuring that patient insurance details are accurate and up-to-date, and that all necessary referrals and authorizations are obtained efficiently.
Key Responsibilities:
- Insurance Verification:
- Verify patient insurance coverage and benefits eligibility.
- Interact with patients, healthcare providers, and insurance companies to obtain necessary information.
- Update insurance and patient information in the system as necessary.
- Prepare and submit insurance claims.
- Follow up on any issues related to insurance verification and claim submission.
- Resolve patient billing and insurance inquiries and disputes.
- Referral Coordination:
- Obtain necessary referrals for office visits and any required authorizations or pre-certifications for procedures.
- Coordinate with medical staff to ensure all necessary documentation for insurance verification and referrals is available.
- Communicate with patients regarding their insurance coverage, benefits, and any required referrals.
- Maintain accurate records of all interactions and documentation for reporting and audits.
- General Duties:
- Ensure compliance with all privacy and confidentiality rules and regulations.
- Maintain a high level of customer service and professionalism in all interactions.
- Perform other duties as assigned by management.
Requirements
- Minimum of 2-5 years of experience in insurance verification and referral coordination.
- Strong understanding of insurance policies, procedures, and medical terminology.
- Excellent communication and interpersonal skills.
- Proficiency in using electronic medical records (EMR) systems and insurance company websites.
- Ability to work independently and as part of a team.
- Strong organizational skills and attention to detail.