Medical Billing/Verifications Specialist

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.