Insurance Verification Specialist

Insurance Verification Specialist

JOB SUMMARY

Verify insurance for procedures being done in the Physician Group Offices. Check with insurance to see if the procedure / medication requires prior authorizations and obtain the authorization as needed.

ESSENTIAL FUNCTIONS

Manage all insurance verification for all patients having procedures / injections

Obtains necessary authorization for procedures / injections

Communicates benefits, potential financial responsibility, available financial assistance from manufacturers of the toxins

Follow-up with patients who have out-of-pocket costs

Performs accurate and timely verifications and entry into the electronic medical records system

Communicate and resolve patient questions regarding insurance or benefits

Contributes to a positive work environment

Contributes to the overall team efforts

Communicates to providers when meds for procedure are required through their Specialty Pharmacy and gets the order

Maintains log of toxin procedures and gives a count to nursing on amounts needed for each provider, logs in authorizations and medications that are received and re-checks the weekly schedules to ensure no patients have been added to the schedule

QUALIFICATIONS :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education

High School Diploma required

Associate's Degree preferred

Work Experience

1-2 years in health insurance verification process preferred (hospital or outpatient experience)

Previous call center experience or similar, high volume environment preferred

Licenses / Certifications

N / A

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