Encora is hiring a
Insurance Verification Specialist

Summary

Join our team as an Authorization Specialist to maintain patient demographic information, review medical history and insurance coverage, and verify eligibility for upcoming appointments.

Responsibilities

• Maintains patient demographic information and data collection systems
• Make necessary updates to each chart to reflect accurate and current information
• Review patient’s medical history and insurance coverage for approval
• Verify insurance eligibility for medical insurances for upcoming appointments by utilizing online websites or by contacting the carriers directly, for each patient in both locations
• Verify Commercial plans for coverage and eligibility for both office locations
• Complete verification form by obtaining the information listed on the form for every Commercial payer
• Review patient deductibles and/or copays and enter the information in the billing system, share with the Front and Billing Department at all locations
• Leave Memos and Notes to communicate changes in Eligibility, Coverage, Carrier, and Amounts Due
• In this role, the candidate will complete authorizations and referrals for the medical services requested by each provider in both office locations
• In addition to reviewing the medical history of potential patients, you verify information provided by their referring physicians and verify their insurance coverage
• You will monitor the schedule for our add-on patients, run appointment reports, ensuring there are no conflicts and that we have the prior authorization we need to move forward with their appointment or procedure
• Candidates will also be responsible for submitting Outbound authorization requests for patients being referred to other specialists
• Approved authorizations must be uploaded into Electronic Health Record program and added to each patient chart to ensure correct services have been approved
• Authorization Specialist will be responsible for communicating with Billing Department regarding changes in insurance information, Denied authorization requests, conflicting appointments, and service requests for each provider