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Med-Metrix

Insurance Verification Representative

Entry-Level JobVerifiedNo experience needed

Career Insights for Eligibility Specialist

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Based on Virginia data

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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.

$51,852 / year median in Virginia

+20% projected growth

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Job Description

Job Purpose The Insurance Verification Representative is responsible for obtaining and providing accurate and complete data input for insurance verifications in clients host systems. Duties and Responsibilities Utilize payer web portals to obtain patients current insurance information and update the information in the client system Verify insurance information against patient's insurance cards scanned in client system and ensure the correct and most up to date information is on the patient's account Once updates are entered in client system, follow procedure on filing the claims Comment all actions taken in internal and client host system Work independently from assigned work queues Meets and maintains daily productivity/quality standards established in departmental policies Adheres to the policies and procedures established for the client/team Communicate effectively with leadership Maintain a professional attitude Other duties as assigned by the management team Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards Understand and comply with Information Security and HIPAA policies and procedures at all times Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties Qualifications High school diploma or equivalent required Insurance Verification knowledge helpful Experience with practice management software: GE Centricity, EPIC PB, Cerner, Allscripts preferred Knowledge of individual payor websites, including eviCore, Navinet and Novitasphere Ability to work well individually and in a team environment Strong organizational and task prioritization skills Proficiency in Microsoft Office Suite. Must have basic Excel skillset Strong communication skills/oral and written Strong organizational skills Strong interpersonal skills, ability to communicate well at all levels of the organization Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses High level of integrity and dependability with a strong sense of urgency and results oriented Excellent written and verbal communication skills required Gracious and welcoming personality for customer service interaction Working Conditions Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
Physical Demands:
While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
Mental Demands:
The employee must be able to follow directions, collaborate with others, and handle stress.
Work Environment:
The noise level in the work environment is usually minimal. Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.