Remote Medical Insurance Verification Specialist

Summary

Join our team as a (Contract) Medical Insurance Verification Specialist and play a crucial role in identifying active coverage for patients, communicating with third-party payers, and updating insurance information in patient records.

Requirements

• Proficient in health insurance verification and benefits
• Knowledge of CPT codes and basic medical terminology (preferred)
• Must be able to work independently in a fast-paced environment
• Exceptional attention to detail
• W9 required - must currently work as a sole proprietor or have or be willing to register a business per independent contractor guidelines
• Reside in the U.S

Responsibilities

• Verify a patient has active coverage with the insured carrier following an inpatient encounter using an electronic eligibility solution
• If the carrier returns ineligible, identify the correct coverage by leveraging the integrated eligibility tool, HL7 interface message, or attached facesheet. If a patient is identified as self-pay, update the financial class
• When coverage returns that an advantage plan has been detected, identify the correct carrier and policy number to be billed using an eligibility solution. Update insurance information in the patient’s record based on the eligibility response
• Identify the correct policy to be billed when a patient is identified as being enrolled in hospice by referencing the eligibility response
• For carriers that do not offer an electronic eligibility response, contact the carrier by phone to complete the verification. A carrier contact list will be provided to facilitate outreach