Position Available In [Unknown county], Florida

BusinessOperations

• Insurance Verification Coordinator I
• 590069 Insurance Verification Coordinator I
• 590069#25-62614
  Various, FL
  All On-site Job Description

Job Description:

Position Purpose:

Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits

Education/Experience:

High school diploma with 1+ years of medical billing or insurance verification experience. Bachelor’s degree in related field can substitute for experience. Experience with payors and prior authorization preferred. Strong customer service skills.

Responsibilities:

• Obtain and verify insurance eligibility for services provided and document complete information in system
• Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
• Collect any clinical information such as lab values, diagnosis codes, etc.
• Determine patient’s financial responsibilities as stated by insurance
• Configure coordination of benefits information on every referral
• Ensure assignment of benefits are obtained and on file for Medicare claims
• Bill insurance companies for therapies provided
• Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
• Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
• Handle inbound calls from patients, physician offices, and/or insurance companies
• Resolve claim rejections for eligibility, coverage, and other issues
  Comments for

Vendors:

EEO:

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of

• Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

” =============

Centene Job Description Position Purpose:

Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits

Education/Experience:

High school diploma with 1+ years of medical billing or insurance verification experience. Bachelor’s degree in related field can substitute for experience. Experience with payors and prior authorization preferred. Strong customer service skills.

Responsibilities:

• Obtain and verify insurance eligibility for services provided and document complete information in system
• Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
• Collect any clinical information such as lab values, diagnosis codes, etc.
• Determine patient’s financial responsibilities as stated by insurance
• Configure coordination of benefits information on every referral
• Ensure assignment of benefits are obtained and on file for Medicare claims
• Bill insurance companies for therapies provided
• Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
• Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
• Handle inbound calls from patients, physician offices, and/or insurance companies
• Resolve claim rejections for eligibility, coverage, and other issues
  Story Behind the Need What is the purpose of this team?

Describe the surrounding team (team culture, work environment, etc.) & key projects.
Do you have any additional upcoming hiring needs or is this request part of a larger hiring initiative? project ascend
Typical Day in the Role Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
What are the performance expectations/metrics?
What makes this role unique? Insurance verification for medication; prior authorization appeals; speak to patients, doctors’ offices, & insurance plans
Inbound internal que
25 referrals/more a day
95% quality or higher
Attendance is crucial Candidate Requirements
Education/Certification

Required:

High school diploma

Preferred:

NA
Licensure

Required:

NA

Preferred:

Years of experience required: 1 + years of expereince

Disqualifiers:

NA Additional qualities to look for: Proficient in Microsoft Office, experience/backgrounds that do well in this role

• Managed Care, Pharmacy, Medical terminology, Physician office experience, Customer Service, Call Center Top 3 must-have hard skills stack-ranked by importance 1 Managed Care
  2 Customer Service
  3 Call Center
  Candidate Review & Selection Shortlisting process
  Candidate review & selection
  Interview information
  Onboard process and expectations

Projected Manager Candidate Review Date:

1-2 days post shortlisting

Type of Interviews:

Teams-camera on
Required Testing or Assessment (by Vendor): Steps Additional background check requirements (List DFPS or other specialty checks here) Do you have any upcoming PTO? Colleagues to cc/delegate Are there any training requirements (time off, alternate schedule, etc.)?