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The Neurology Center

Medical Insurance Verification Specialist

Career Insights for Eligibility Specialist

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What they do

An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.

$54,990 / year median in California

+4% projected growth

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Job Description

Medical Insurance Verification Specialist The Neurology Center - 3.6 Carlsbad, CA Job Details Full-time $24 - $25 an hour 1 hour ago Qualifications Health insurance authorizations Medicare Managed care Electronic health records (EHR) management Medical insurance coverage verification Managed care organization experience Medicaid health insurance Healthcare referral management Computer skills Medicaid Health insurance referral requirements
Full Job Description Description:
We are seeking an experienced Medical Insurance Verification Specialist to join our growing neurology practice. This is not an entry-level position . The ideal candidate must have a strong understanding of medical insurance plans, eligibility verification, authorizations, and managed care. Candidates without direct medical insurance verification experience will not be considered.
Requirements:
Minimum of 2 years of medical insurance verification experience in a physician practice or specialty clinic. HMO and PPO insurance plans Medicare and Medicare Advantage Medi-Cal Commercial insurance plans IPA/Medical Groups Referral and authorization requirements Experience working with major California health plans and medical groups. Strong understanding of insurance eligibility and benefit verification. Excellent attention to detail and problem-solving skills. Ability to prioritize work in a fast-paced medical environment. Strong computer skills and experience using an EMR. Experience navigating
Insurance Portals Responsibilities:
Verify patient insurance eligibility and benefits prior to appointments. Review referrals and authorization requirements. Understand and verify HMO, PPO, Medicare, Medicare Advantage, Medi-Cal, and commercial insurance plans. Identify contracted and non-contracted health plans and medical groups. Verify PCP assignments and medical group affiliations. Obtain and document insurance information accurately in the electronic medical record (EMR). Communicate with insurance companies, medical groups, referring offices, and patients regarding coverage and authorization requirements. Resolve insurance discrepancies prior to patient appointments. Work closely with scheduling, referrals, and clinical staff to ensure timely patient care. Maintain strict confidentiality Self-motivated with a strong work-ethic, solid interpersonal skills and excellent organization and prioritization skills. Excellent phone etiquette and customer service skills •Work efficiently under deadlines •Dependable / Punctuality is a must.