CCS Medical

Insurance Verification Representative

US-FL-Clearwater
ID
2017-2100
Category
Administrative/Clerical
Position Status
Regular Full-Time
Position Schedule
Monday-Friday
Shift
9:30 - 6:00

Overview

Qualifies patients’ insurance coverage and ensures patient orders are accurate and complete prior to shipment.

Responsibilities

Essential Duties:

  • Contacts Medicare, Medicaid and private insurance companies, by phone or internet tools, to obtain benefit and eligibility information
  • Efficiently and accurately verifies, reviews, documents and completes insurance verifications
  • Evaluates insurance coverage in order to determine the policy’s compatibility with our program
  • Determines if selected products are appropriate based on patient need and insurance benefit plan
  • Communicates with operations, sales team, referral or patient, regarding insurance benefits and coordination with products and programs
  • Achieves stated revenue goals, production, and performance objectives
  • Escalates recurring problem accounts, physician groups, or other trends to the management appropriately and in a timely manner
  • Maintains advanced knowledge of specialty and ancillary products to answer patient questions and assist with accurately processing complex orders, including out-of-stock items, exchanges and returns      
  • Maintains a high degree of confidentiality at all times due to access to sensitive information
  • Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
  • Follows all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements
  • Abides by all regulations, policies, procedures and standards

 

Performance Responsibilities:

  • Exercises appropriate cost control measures
  • Maintains positive internal and external customer service relationships
  • Maintains open lines of communication
  • Plans and organizes work effectively and ensures its completion
  • Meets all productivity requirements
  • Demonstrates team behavior and promotes a team-oriented environment
  • Actively participates in Continuous Quality Improvement
  • Represents the organization professionally at all times

Qualifications

  • High School diploma and one to two years of medical insurance verification or equivalent combination of education and experience
  • One to two years of customer service experience preferred
  • Has a strong working knowledge of billing procedures, insurance reimbursement procedures and HCPC codes
  • Ability to adapt to a constantly changing environment
  • Proficient in Microsoft Outlook, Word, Excel, PowerPoint and computer literacy
  • Knowledge of government and commercial insurance payers as it relates to documentation of claims that are required before submission
  • Ability to read and interpret documents such as Medicare/Medicaid regulations and insurance documents
  • Position may require evening and weekend availability
  • Strong attention to detail, multi-tasking, communication, and organizational skills are essential
  • Demonstrated ability to accurately perform data entry and pay close attention to detail

Equal Opportunity Employer/Veterans/Disabled

 

Options

Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed