Ins Verification Speclst - Full-time

Join the country’s leading Cardiac PET provider! Cardiac Imaging Inc. (CII) is looking for talented and ambitious professionals to join our dynamic team and improve patient outcomes across the nation.

Despite heart disease being the leading cause of death in the US, most physicians and patients do not have access to the leading technology in Cardiology. At CII, our mission is to create a more accessible healthcare system by enabling all physicians to treat their patients with the most advanced technology – all from the comfort of their own practice. Our innovative team drives this mission forward each and every day with our Mobile and Fixed Cardiac PET Solutions. As we continue to grow, we currently have a tremendous opportunity for an Insurance Verification Specialist who is up for the challenge.  

Summary/Objective:

The Insurance Verification Specialist is responsible for verifying patients’ insurance/benefits coverage for Advanced Diagnostic Imaging, PET/CT, tests and procedures.  They review the insurance documents of the patient, including coverage and limitations and escalate concerns to the RCM Director for immediate resolution.  The Insurance Verification Specialist communicates with insurance companies, billing team, and physician liaison specialists to ensure accurate billing and reimbursement for the PET/CT test.  The role requires attention to detail, strong communication skills, time management skills and extensive knowledge of insurance policies.

Essential Functions:

The following list of essential functions is not intended to be restrictive or all inclusive. The fact that certain duties may not be listed does not limit the assignment of additional and/or other duties. 

• Obtain insurance eligibility and benefit information using various phone and on-line resources.
• Obtain appropriate authorizations and notifies insurance companies of patient date of service as needed.
• Works with corporate scheduling staff and/or physicians’ offices to assure eligibility and authorization requirements are completed within the required timeframe.
• Communicates with the appropriate scheduling or billing staff when changes are made to the service date that will affect the reimbursement.
• Identifies appropriate corrections in the patient’s record to ensure accuracy in order to prevent denials and/or problems with billing and reimbursement.
• Immediately refers ‘at risk’ admission to eligibility, i.e., out of network, underinsured, max benefits, etc.
• Works with insurance eligibility responses and physician's staff and patients as needed to resolve billing issues and prevent billing delays.
• Maintains a satisfactory level of performance and adherence to workload standards.
• Estimates reimbursement and calculates expected payment based on appropriate fee schedules.
• Performs calculations using insurance benefit information to accurately estimate patient responsibility.
• Other related duties as assigned

Qualifications and Requirements: 

• High school diploma or GED equivalent
• Three (3) or more years of billing, collection, and insurance verification experience
• Demonstrated knowledge of CPT/ICD-9 & ICD-10 codes
• Demonstrated knowledge of medical billing terminology
• Physician relations experience preferred
• Experience using Microsoft Office Suite and ability to learn new software quickly
• Excellent communication skills with all levels of medical office (physicians, practice managers, consultants, external vendors and peers)
• Strong organizational and time management skills
• Ability to set and keep appointments
• Strong analytical skills, attention to detail and accuracy
• Consistent follow through
• Bilingual in Spanish a plus
• Ability to learn company policies and adhere to them in the performance of all assigned duties and communicate any compliance deviations to management in a timely manner

Benefits:

We believe taking care of our people is the right thing to do. Cardiac Imaging believes that its dedicated employees are its most valuable resource. Employees at Cardiac Imaging are provided with a professional and comfortable work environment, along with a generous benefit package.

• Paid Holidays
• Paid Time Off
• Medical/Dental/Vision Insurance
• Flexible Spending Account (FSA)
• Healthcare Savings Account (HSA)
• Voluntary Short-Term Disability
• Long Term Disability
• Life Insurance/AD&D
• Parental Leave
• Voluntary Life Insurance/AD&D
• Voluntary Accident
• 401(k)
• Career Growth and opportunities for advancement

•  Cardiac Imaging is an equal opportunity employer that is committed to inclusion and diversity. We take affirmative action to ensure equal opportunity for all applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics.   Cardiac Imaging is a drug-free workplace and uses E-Verify to confirm the identity and employment eligibility of all new hires.
• Employer reserves the right to offer the selected candidate or applicant an hourly rate or salary at an appropriate level to be set and determined by the employer that is commensurate with the applicant’s qualifications, experience, education, skills, training, certifications, or seniority