BusinessOperations – Insurance Verification Coordinator I Insurance Verification Coordinator I Position Available In [Unknown county], Florida
Tallo's Job Summary: The Insurance Verification Coordinator I position, located in various areas in Florida, requires a high school diploma and at least 1 year of medical billing or insurance verification experience. Responsibilities include obtaining and verifying insurance eligibility, performing prior authorizations, and coordinating benefits. The role involves handling inbound calls from patients, physician offices, and insurance companies. This position is offered by Centene, an Equal Opportunity Employer.
Job Description
BusinessOperations – Insurance Verification Coordinator I Insurance Verification Coordinator I#25-59503
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.)?
