CCS Medical

  • Insurance Verification Representative

    Job Location US-FL-Clearwater
    ID
    2019-2296
    Category
    Administrative/Clerical
    Position Status
    Regular Full-Time
    Position Schedule
    Monday-Friday
    Shift
    9:30-6:30
    Alternative Schedule
    2 mandatory late nights per month: last Fri of mo. AND last day of month until 8 PM
  • Overview

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

    Responsibilities

    • 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

    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

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