Insurance Specialist

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As an Insurance Specialist, you will provide expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance information. You will also develop and maintain positive relationships with referring physicians and patients.

This position is full-time Monday-Friday, 8:30am-5:00pm.

Essential Duties And Responsibilities

(65%) Insurance Administration

• Prioritizes workload to ensure all patients are authorized prior to their exam
• Determines if patient's insurance is a part of the provider network
• Makes outgoing calls to insurance companies for pre-certification or any authorization
• Receives pre-authorization from patients and/or insurance companies and documents
• Contacts patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed
• Accurately enters a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system
• Maintains positive interactions with referring offices, patients and staff
• Obtains signs and symptoms in order to support medical necessity
• Obtains all workers compensation approvals from insurance companies prior to scheduled exam
• Completes payor-related information i.e., payor, payor class, date of appointment
  
  

(30%) Price Quotes

• Verifies insurance eligibility and benefits
• Calculate patients expected financial responsibility
• Notify patients of expected financial responsibility
  
  

(5%) Completes other duties as assigned