SUMMARY Provides leadership and operational support for Greenwood Pediatrics' insurance verification process by ensuring patient insurance is verified prior to appointments, proactively obtaining updated insurance information when needed, and promoting accurate, timely eligibility verification. Serves as the primary liaison between the Patient Representative team and Billing to improve communication, streamline workflows, and support an efficient revenue cycle. The Insurance Verification Lead is a member of the Patient Representative Lead Team, providing cross-coverage for Patient Representative Leads while receiving reciprocal support for insurance verification responsibilities. This position supports all Greenwood Pediatrics locations and travels between the Littleton, Parker, and Centennial offices as operational needs require.

ESSENTIAL

DUTIES and

RESPONSIBILITIES

Include, but are not limited to, the following: Treats patients and families with respect and sensitivity and exhibits behavior which projects a caring and compassionate attitude consistent with the philosophy of Greenwood Pediatrics. Verifies patients' health insurance eligibility and benefits prior to scheduled appointments. Reviews upcoming schedules to ensure insurance verification is completed before the date of service whenever possible. Utilizes insurance verification portals and payer resources to confirm eligibility, active coverage, copayments, deductibles, coinsurance, referral requirements, and authorization requirements according to training standards. Proactively contacts patients to obtain updated insurance information and copies of insurance cards prior to their appointment whenever possible to reduce registration delays, registration errors, and claim denials. Ensures insurance information is accurately documented within the electronic health record. Identifies insurance discrepancies and collaborates with patients, the Billing Department, and Patient Representatives to resolve issues before the patient's visit. Serves as the primary liaison between the Front-End Operations team and the Billing Department, ensuring timely communication regarding payer updates, workflow changes, denials, registration requirements, and insurance-related trends. Collaborates closely with the Billing team and Patient Representative Team Leads to improve workflows, reduce registration errors, and strengthen revenue cycle performance. Provides education and communicates insurance verification updates, payer requirements, workflow changes, and best practices to Patient Representatives and Patient Representative Leads. Helps maintain consistency between front-end registration practices and billing requirements through ongoing collaboration, education, and process improvement. Develops, implements, and maintains insurance verification workflows, reference materials, and standard operating procedures. Monitors insurance verification quality, identifies trends, and recommends process improvements that increase first-time verification accuracy and reduce avoidable billing issues. Tracks departmental performance metrics such as insurance verification completion rates, pre-visit verification timeliness, same-day insurance issues, and registration-related denials, reporting trends and opportunities for improvement to management. Performs routine quality audits of insurance verification work and provides coaching, education, and feedback to promote consistency and accuracy. Participates as an active member of the Patient Representative Lead Team, supporting department initiatives, workflow coordination, operational excellence, and continuous process improvement. Provides operational coverage for Patient Representative Leads during absences and periods of increased workload and receives reciprocal support for insurance verification responsibilities as needed. Assists management with special projects, workflow redesign, implementation of new payer processes, and other initiatives that improve both patient experience and financial performance. Performs duties of a Patient Representative or Insurance Verification Specialist as operational needs require. Performs general clerical duties including scanning, faxing, filing, emailing, and other administrative support. Performs project-based work as assigned by Administration.

SUPERVISORY RESPONSIBILITIES

This job has no supervisory responsibilities, although has the authority to request information and receive cooperation from all staff.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. EDUCATION and/or

EXPERIENCE

One to three months related experience and/or training; or equivalent combination of education and experience. College level education preferred.

LANGUAGE SKILLS

Ability to read, analyze and interpret general business information, technical procedures or government regulations. Ability to create reports and effectively present information and respond to questions from managers, teammates, patients, and patient families.

REASONING ABILITY

Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. OTHER QUALIFICATIONS, SKILLS and

ABILITIES

This position requires strong data management skills, excellent written and verbal communication skills, strong planning, motivating, and decision-making skills, as well as creativity and excellent telephone skills. The ability to collaborate with others, working in team settings while recognizing and respecting cultural differences. Must be detail oriented with the ability to organize, prioritize and coordinate multiple tasks as well as switch tasks is required. The ability to remain calm and be effective in emergency situations is a must. Must be professional, flexible, caring, and compassionate and exhibit a congenial and sensitive attitude toward patients. Must have computer skills including electronic health records (EHR) systems, Microsoft Outlook, Word and Excel and other basic office software programs. Ability to work independently and creatively. Ability to meet deadlines in a fast-paced environment.

APTITUDES

Must have a high level of energy with the ability to adjust to any justifiable pace, make decisions based on fact rather than emotion, and exhibit behavior which emphasizes compassion, quality, loyalty and conscientiousness. Must have the ability to establish and maintain effective working relationships with patients, their families and staff members.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel and talk or hear. The employee is required to stand, walk, sit, and reach with hands and arms. The employee is occasionally required to stand and stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision and ability to adjust focus.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. The noise level in the work environment is usually moderate.

Job Type:

Full-time Pay:

$20.00 - $22.00 per hour

Benefits:

401(k) Dental insurance Disability insurance Employee assistance program Health insurance Life insurance Paid time off Vision insurance Application Question(s): Are you able to reliably commute to multiple locations in the south Denver metro area and in inclement weather?

Experience:

Medical office: 1 year (Required)

Work Location:

In person