RCM INSURANCE VERIFICATION SPECIALIST performs clerical functions for patient billing, including verification of insurance information and resolution of problems to ensure a clean billing process. Follows up on accounts that require further evaluation. Works with others in a team environment. Essential Functions:
- Maintains patient demographic information and verifies, enters or updates insurance information for new patients and existing patients to include copays and deductibles
- Verify insurance eligibility for upcoming appointments by utilizing EMR, online websites or by contacting the carriers directly.
- Explain financial responsibilities to patients.
- Coordinate with staff and management regarding scheduling errors.Update the error spreadsheet daily.
- Enter insurance effective dates and/or authorization details.
- Participates in development of organization procedures and update of forms and manuals.
- Answers questions from patients, clerical staff and insurance companies.
- Works in conjunction with the reception to ensure clean billing.
- Performs miscellaneous job-related duties as assigned.
- Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- Assists in development and communication of SOP for key areas to improve accuracy and understanding of processes.
Process:
- Check assigned locations daily and confirm eligibility, copay, and outstanding balance for every scheduled patient.
- Enter and update carrier details in the insurance section of the patient account to include plan name, effective dates, co-pays and deductibles.
- Flag and address potential errors.All errors should be logged onto the Eligibility Error Spreadsheet
- Add copay and outstanding collection notes in the appointment details for the PSR to see and address during the check in process.
- If further action is needed, due to portal downtime or insurance errors, enter notes into the appointment details for the PSR to see.
- Maintain regular verification management at least two days ahead of schedule
- Attempt to collect outstanding balances and/or work with RCM management to assist with questions
Qualifications:
- Minimum of 1 year working in a medical office.
- Medical Billing experience preferred.
- Must be comfortable asking for payment.
- Must have outstanding phone etiquette and attention to detail.
Benefits:
- Medical, Dental, Vision Coverage
- Life Insurance
- Paid Time Off
- Long Term Disability
- 401K Plan
Job Type: Full-time