Insurance Verification Specialist and Referral Coordinator

Insurance Verification Specialist and Referral Coordinator Rheumatology Alliance LLC Dallas, TX Job Details 6 hours ago Qualifications Customer communication Electronic health records (EHR) management Medical insurance coverage verification Healthcare referral management Medical records Health insurance referral requirements Medical terminology

Full Job Description Description:

Position Summary:

We are seeking a detail-oriented and experienced Eligibility Insurance Verification Specialist and Referral Coordinator to join our team. The ideal candidate will have 2-5 years of experience in insurance verification and referral coordination within a healthcare setting. This role is critical in ensuring that patient insurance details are accurate and up-to-date, and that all necessary referrals and authorizations are obtained efficiently.

Key Responsibilities:

Insurance Verification:

Verify patient insurance coverage and benefits eligibility. Interact with patients, healthcare providers, and insurance companies to obtain necessary information. Update insurance and patient information in the system as necessary. Prepare and submit insurance claims. Follow up on any issues related to insurance verification and claim submission. Resolve patient billing and insurance inquiries and disputes.

Referral Coordination:

Obtain necessary referrals for office visits and any required authorizations or pre-certifications for procedures. Coordinate with medical staff to ensure all necessary documentation for insurance verification and referrals is available. Communicate with patients regarding their insurance coverage, benefits, and any required referrals. Maintain accurate records of all interactions and documentation for reporting and audits.

General Duties:

Ensure compliance with all privacy and confidentiality rules and regulations. Maintain a high level of customer service and professionalism in all interactions. Perform other duties as assigned by management.

Requirements:

Minimum of 2-5 years of experience in insurance verification and referral coordination. Strong understanding of insurance policies, procedures, and medical terminology. Excellent communication and interpersonal skills. Proficiency in using electronic medical records (EMR) systems and insurance company websites. Ability to work independently and as part of a team. Strong organizational skills and attention to detail.