Medical Billing/Verifications Specialist
Job Type
Full-time
Description

  

This person is responsible for insurance verification, obtaining prior authorizations, bill insurance claims and follow-up.  

· Obtain authorizations, referrals, GAP exceptions, and Single Case Agreements 

· Manage and prioritize required approvals with consistent follow-up while constantly communicating with the team

  • Provide clinical documentation to insurance companies to ensure      timely authorization.
  • Initiate appeals for upfront denied authorizations and follow      through until completion
  • Check eligibility and benefits
  • Electronic claims building and submission
  • Chart and coding review
  • Call patients when necessary to verify insurance information
  • Read and analyze EOBs and ERAs
  • Work claims rejects/denials, send corrected claims, submit appeals
  • Stay up to date on CPT, ICD, and LCD guidelines
  • Provide excellent customer service and professionalism to patients
Requirements

  

Skills, Minimum Qualifications

  • High school diploma or GED
  • 2 years prior experience insurance verification or medical billing      required
  • 2 years prior experience in a medical related field required
  • Ability to multi-task and remain focused while managing a high      volume, time-sensitive workload
  • Demonstrate excellent communication and customer service skills
  • Expected to be detailed oriented with above average organizational      skills
  • Expected to understand payer medical policies and guidelines and use      these guidelines to manage authorizations effectively
  • Familiarity with both governmental and commercials insurance plans
  • Expected to have knowledge of medical terminology related to      multispecialty surgical procedures
  • Expected to have excellent computer skills including Excel, Word and      Internet use
  • Reliable to work scheduled shifts with limited unplanned absences. 

Please note that this position is not remote and requires employees to travel to work location.