Experience Inc. Jobs

Title:Insurance Verification Specialist (IVS) Recommended by:Chief Financial OfficerApproved by:Chief Executive Officer FLSA status: Non-Exempt Reports to:Director ofRevenue Cycle Management Status: Full Time: 40 hours per week Personnel Supervised: None

POSITION SUMMARY: Under general supervision the IVS is responsible for verifying insurance benefits, obtaining pre-authorization and authorizations for all services rendered by the provider assigned to the team member. Works closely with center leaders, center staff and insurance companies to verify the patient's individual benefits. Relies on extensive experience of the authorization process, understanding of insurance and ability to work independently in order to meet the goals of the dept.

MINIMAL QUALIFICATIONS:

• High school graduate or equivalent required
• 3-5 years healthcare experience working in the primary care or other specialties required
• Knowledge of medical terminology or concepts is required
• Proficiency in Microsoft Office applications including Word, Power Point, Excel, and Outlook is required

RESPONSIBILTIES AND PERFORMANCE EXPECTATIONS include, but are not limited to, the following:

• Responsible for the Insurance benefits and authorization process.
• Submit Authorization to Insurance companies to include the use of Cover my Meds and Availity software among others.
• Submit additional paperwork, documentation necessary to Authorize a medication or service.
• Responsible for correctly identifying and updating various types of insurance entry information.
• Understanding of the different product websites in order to get discounted pharmaceuticals for a patients benefit.
• Correctly document patient charts and complete the Authorization forms to assist coders in processing claims.
• Work closely with the Provider, their nurses and other team members in order to make the treatment process seamless.
• The ability to speak with different insurance companies via phone to identify correct coverage, benefit details and authorization needs.
• Proper phone etiquette when speaking with Providers, staff and patients.
• Strong organizational and time management skills.
• Maintain Company dashboards

Knowledge of:

• Federal laws and regulations affecting coding requirements
• Electronic Health Records
• Knowledge of billing practices and billing office functions including FQHC environment
• Knowledge of medical records, E H R
• Must have good math skills and effective communication skills
• Must have good problem-solving skills

Responsibility, Skills, and Difficulty of Work:

• Communicating clearly and concisely, orally and in writing
• Confidentiality
• Ability to use the computer
• Ability to work independently to accomplish assigned work in a timely manner
• Ability to communicate with staff and the public, both in person and over the phone, in a tactful manner and under difficult situations
• Understanding and carrying out verbal and written directions
• Follow CFHC policies and procedures
• Ability to work independently

PHYSICAL REQUIREMENTS:

• Works under pressure and stress due to the diversity of our clinics
• Work is performed indoors in a heated, air conditioned, well lighted and clean office setting
• Requires ability to distinguish letters, numbers and symbols
• Requires normal range of vision
• Requires awareness of personal limitations and flexibility
• Some emotional stress resulting from diversity and intensity of patients and staff
• Requires prolonged standing or sitting
• Occasional travel required

American with Disabilities Act (ADA) Statement: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job responsibility) either unaided or ith the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.