CCS Medical

Re-Verification Representative

Job Location US-FL-Clearwater
ID
2018-2166
Category
Customer Service/Support
Position Status
Regular Full-Time
Position Schedule
Monday-Friday
Shift
9:30 - 6:00

Overview

Qualifies existing patients’ insurance coverage in order to determine its compatibility with our program.

Responsibilities

  • Makes outbound calls to insurance companies to verify insurance benefits 
  • Evaluates insurance coverage in order to determine the policy’s compatibility with our program
  • Recommends the appropriate products based on the patient’s needs and insurance coverage
  • Efficiently and accurately verifies, reviews, documents and completes insurance verifications
  • Identifies and initiaties documentation needs and requests to permit timely billing of services and communication with appropriate team(s)
  • Reviews patient accounts and determines appropriate action(s) needed to collect payment
  • Reviews claims and performs claim corrections and submissions to new carrier based on new plan verification
  • Has a strong working knowledge of billing procedures, insurance reimbursement procedures and HCPC codes
  • Ability to analyze and correct accounts receivable problems
  • Assists other office personnel in the performance of their duties as assigned and as workload permits
  • Maintains regular and consistent attendance

OTHER RESPONSIBILITIES

  • Participates in educational programs and in-house meetings on product information and new procedures
  • Maintains and promotes patient confidentiality
  • Maintains open lines of communication with Administration, department management and other departmental personnel
  • Follows all Medicare, Medicaid and Private Insurance regulations and requirements
  • Actively participates in Continuous Quality Improvement
  • Demonstrates thoroughness with all work related activities. 
    Strives to continually improve quality and productivity results
    displayed by Department Personnel on an ongoing basis
  • Assumes other duties and responsibilities as assigned by manager
  • Abides by all policies, procedures and protocols set forth in the departmental, CCS Medical Personnel and Administrative Policy Manuals
  • Maintains scheduling flexibility to ensure availability to meet the needs of the department for all hours of operation

Qualifications

  • High school diploma or GED equivalent and 1or more years of medical insurance verification or medical collections experience or relevant experience within CCS Medical.
  • Ability to read and interpret documents such as Medicare/Medicaid regulations, operating and maintenance instructions, and procedure manuals
  • Ability to write routine reports and correspondence
  • Ability to speak effectively to patients, health care providers and employees of the organization
  • Ability to add, subtract, multiply and divide all units of measure, using whole numbers, common fractions and decimals; ability to compute rate, ratio and percent and to draw and interpret bar graphs
  • Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form  
  • Ability to deal with problems involving several concrete variables in standardized situations

Equal Opportunity Employer/Veterans/Disabled

 

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