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Assists with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution. Provides support in ensuring accurate billing, efficient revenue flow, and compliance with regulations.
Job Responsibility:
Gathers necessary information to verify critical member benefits insurance coverage
Reviews insurance plans and policies to determine coverage extent
Contacts insurance providers to verify eligibility and coverage limits
Explains verification process and provides updates
Maintains accurate records of insurance verification activities
Communicates authorization requirements and coverage limitations
Investigates and resolves challenges during verification process
Proposes process enhancements to streamline operations
Responds to member inquiries promptly and professionally
Requirements:
Less than 1 year work experience
High School Diploma
Certified Professional, Life and Health Insurance Program (CPLHI) preferred