Medical Insurance/Eligibility/Financial Specialist

Location: Crystal Grove Office          

Reports To: Insurance Supervisor          

Type of Shift: Full Time          

JOB SUMMARY: The Insurance Specialist verifies benefits and obtains authorizations for all exams scheduled in an efficient and timely manner while maintaining a high level of customer service. Administration of the insurance process includes verifying insurance and obtaining appropriate authorizations to ensure quality patient care and satisfaction.              

JOB RESPONSIBILITIES:              

1. Obtains authorization/pre-certification for the correct scheduled exams of assigned facility.               

2. Effectively uses task work list and inputs insurance benefits and authorizations in the proper context and location.              

3. Maintains/updates current insurance authorization requirements. When changes are made, insurance requirement list is distributed appropriately.                    

4. Receives internal and external telephone calls to answer questions and resolve problems regarding insurance benefits, verifications, and/or authorizations in a concise and courteous manner.                

5. Effectively communicates benefits and authorization/precertification problems to the referring physician, patient, and/or RIS facility as needed.                   

6. Schedules and reschedules patient appointments when needed from the scheduling phone queue or incoming phone calls.                     

7. Maintains patient confidentiality and complies with HIPAA guidelines.                 

8. Performs related work as required.                   

9. Customer Service.                   

WORK EXPERIENCE/EDUCATIONAL REQUIREMENTS:              

2 or more years in the Medical Insurance Field preferred.                  

High school diploma or GED.                                                       

SKILLS/PHYSICAL REQUIREMENTS:           

Skills in establishing and maintaining effective working relationships with staff, patients and referring physician offices, and the ability to work independently.                   

This job requires prolonged sitting; Normal vision range with the absence of color blindness, normal hearing, and normal eye to hand coordination and manual dexterity; the ability to distinguish letters and symbols. This position may require lifting up to 25 pounds.