Insurance Verification Specialist

• Verify insurance eligibility and benefits for patients using payer portals, phone calls and electronic systems
• Review and interpret insurance plans, coverage limitations, exclusions and coordination of benefits
• Calculate patient financial responsibility including deductibles, co-pays, co-insurance and non- covered services
• Obtain prior authorizations, referrals and pre-certifications when required by insurance carriers
• Document all verification details, benefit information, and communications in the billing system
• Identify payer trends and establish payer-specific strategies to overcome reimbursement challenges
• Communicate effectively with patients regarding their insurance benefits, financial estimates and payment options
• Contact patients/families/caregivers/Clients and Account Executives as needed to obtain current demographics, insurance, physician, and device usage, to ensure appropriate insurance reimbursement

• High school diploma or equivalent required, Associate’s or Bachelor’s degree preferred
• 2+ years of healthcare related experience in the revenue cycle process with a specialized focus around eligibility and benefit verification, claims submission
• Knowledge of Federal, State, and Local regulations, guidelines, and standards, payer rules, medical coding basics (ICD-10, CPT) including a working knowledge of HIPAA rules and regulations
• Experience with medical record reviews to identify and ensure medical necessity
• Ability to work independently and in a team environment
• Possess the ability to manage time and prioritize critical priorities
• Proficiency in Microsoft Office Software

Cardiology related experience a plus

• Support for Parents
• Continuing Education/ Professional Development
• Employee Heath & Well-Being Benefits
• Paid Time Off
• 2 Days a Year to Volunteer
• medical and dental coverage that start on day one
• insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
• Employee Stock Purchase Plan (ESPP)
• 401(k) Retirement Savings Plan (RSP)
• Flexible Spending Accounts
• educational assistance programs
• paid holidays
• paid time off ranging from 20 to 35 days based on length of service
• family and medical leaves of absence
• paid parental leave
• commuting benefits
• Employee Discount Program
• Employee Assistance Program (EAP)
• childcare benefits