Insurance Verification Specialist and Referral Coordinator

Description

Position Summary: We are seeking a detail-oriented and experienced Eligibility Insurance Verification Specialist and Referral Coordinator to join our team. The ideal candidate will have 2-5 years of experience in insurance verification and referral coordination within a healthcare setting. This role is critical in ensuring that patient insurance details are accurate and up-to-date, and that all necessary referrals and authorizations are obtained efficiently.
Key Responsibilities:

• Insurance Verification:
  • Verify patient insurance coverage and benefits eligibility.
  • Interact with patients, healthcare providers, and insurance companies to obtain necessary information.
  • Update insurance and patient information in the system as necessary.
  • Prepare and submit insurance claims.
  • Follow up on any issues related to insurance verification and claim submission.
  • Resolve patient billing and insurance inquiries and disputes.
• Referral Coordination:
  • Obtain necessary referrals for office visits and any required authorizations or pre-certifications for procedures.
  • Coordinate with medical staff to ensure all necessary documentation for insurance verification and referrals is available.
  • Communicate with patients regarding their insurance coverage, benefits, and any required referrals.
  • Maintain accurate records of all interactions and documentation for reporting and audits.
• General Duties:
  • Ensure compliance with all privacy and confidentiality rules and regulations.
  • Maintain a high level of customer service and professionalism in all interactions.
  • Perform other duties as assigned by management.

Requirements

• Minimum of 2-5 years of experience in insurance verification and referral coordination.
• Strong understanding of insurance policies, procedures, and medical terminology.
• Excellent communication and interpersonal skills.
• Proficiency in using electronic medical records (EMR) systems and insurance company websites.
• Ability to work independently and as part of a team.
• Strong organizational skills and attention to detail.