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Medical Insurance Verification Specialist
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Midwest Nephrology Associates, SC
Milwaukee, WI (In Person)
$45,760 Salary, Full-Time
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Job Description
Multiple physician office is seeking an experienced and qualified Medical Insurance Verification Specialist to work in the physician clinic located in Milwaukee, WI. This role serves as a critical link between patient access and billing, impacting both the patient experience and the financial health of the practice by ensuring every coverage and authorization is secured prior to services being rendered. This candidate should possess confidence in their abilities, is well organized, and have an exceptional ability to multitask. Responsibilities and Duties Verifies patient insurance eligibility and benefits in advance of all scheduled appointments, ensuring information is entered accurately and in full in EMR for all patients. Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicaid, and third-party payor requirements/on-line eligibility systems. Manage Prior authorization work queue, initiating prior authorizations for all required services. Monitor prior authorization timelines and expiration dates, initiating renewals as needed to prevent gaps in servicesMonitors the referral status for MNA patients Identify patients who are out of network or self-pay and provide them a self-pay estimate within the No Surprise Act required timeframes. Contacts insurance carriers to obtain benefit coverage, policy limitations, authorizations/notifications, pre-certifications for patients. Notify patients of their co-payment obligation and collect at time of clinic appointment. Enter patient profiles and updates into EPIC system. Stays current on payer requirements and policy changes and work with billing supervisor and Practice Administrator to implement required changes Educates patients, staff and providers regarding referral and authorization requirements, payor coverage, eligibility guidelines, documentation requirements, and insurance related changes or trends. Maintain a high degree of professionalism in both appearance and presentation at all times. Maintain confidentiality regarding all matters of patient, physician and financial affairs. Perform duties in a safe and efficient manner according to the policies and procedures of Midwest Nephrology Associates. Qualifications and Skills 2 years of medical insurance verification experience required Understanding of common medical terminology and insurance eligibility qualifiers EPIC experience preferred Excellent communication skills, verbal and written. Ability to communicate well with patients, families, co-workers and others. Ability to work as a team and independently