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Visionary Billing Solutions LLC

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.

$44,207 / year median in Florida

+17% projected growth

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Job Description

Job Overview:
This position is with a third-party billing company that services Substance Abuse and Mental Health Facilities. The Insurance Verification Specialist will be responsible for contacting insurance companies to verify insurance information for potential admitting patients in behavioral health and substance abuse settings. Using internal processes, the representative will obtain detailed insurance data, check patient eligibility and benefits, and input the information into the Electronic Medical Record (EMR) system.
Key Responsibilities:
Contact health insurance companies to verify patient benefits and eligibility for behavioral health and substance abuse services. Accurately input verified insurance data directly into the EMR database. Follow internal procedures to gather the necessary insurance information for potential admitting patients. Adhere to company and client standards, with training provided to ensure alignment with protocols. Maintain HIPAA compliance and manage sensitive patient information with confidentiality.
Summary:
As an Insurance Verification Representative, you will play a vital role in ensuring the accuracy and timeliness of insurance verifications for patients at behavioral health and substance abuse facilities. Reporting to the Verifications of Benefits Manager, you will utilize your knowledge of medical terminology, coding, and insurance verification processes to streamline patient admissions. Your understanding of managed care and HIPAA regulations will contribute to efficient operations while enhancing the patient experience.
Qualifications:
Previous office experience in a medical setting, preferably within a behavioral health or substance abuse context. Proficient in medical terminology and verification of benefits. Strong understanding of medical coding, including CPT and
ICD-9/ICD-10
codes. Experience with insurance verification processes and eligibility inquiries. In-depth knowledge of HIPAA regulations and patient confidentiality. Proficiency in computer systems and familiarity with software applications, including Salesforce, Availity, and Kipu EMR.
Job Type:
Full-time Pay:
$18.00 - $22.00 per hour
Benefits:
401(k) Dental insurance Health insurance Paid time off Vision insurance Application Question(s): Do you have a LinkedIn? If so, please provide the link.
Education:
High school or equivalent (Required)
Experience:
Insurance verification: 1 year (Required)
Language:
English (Required)
License/Certification:
Driver's License (Required)
Location:
Delray Beach, FL 33484 (Preferred)
Work Location:
In person