Find & Apply For Clinical Data Systems Specialist Jobs in Cranston, Rhode Island

Overview We are seeking a proactive and detail-oriented Insurance Verification Coordinator to join our busy 4 location Optometric practice. In this vital role, you will be responsible for verifying patient insurance coverage, ensuring accurate billing information, and facilitating smooth communication between patients, providers, and insurance companies. Responsibilities Verify patient insurance coverage by reviewing health insurance policies, managed care plans, vision care plans and electronic health records (EHR) to confirm eligibility and benefits. Obtain prior authorization for procedures and treatments by coordinating with insurance companies and healthcare providers. Accurately input and update medical records, insurance information, and billing details using EMR/EHR systems and Microsoft Office tools. Ensure compliance with HIPAA regulations and clinical confidentiality policies while handling sensitive medical records and patient data. Communicate effectively with patients, healthcare providers, and insurance representatives to resolve coverage issues or discrepancies promptly. Review medical coding including CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding to support accurate billing processes. Maintain detailed documentation of all verification activities, insurance approvals, denials, and follow-up actions to ensure audit readiness. Qualifications Prior experience in a medical office or healthcare setting with knowledge of health insurance policies and managed care processes. Strong understanding of medical terminology, medical billing, medical coding (CPT, ICD-9/10), and insurance verification procedures. Familiarity with EMR/EHR systems and electronic health records management. Excellent customer service skills with the ability to communicate clearly and professionally across diverse audiences. Knowledge of HIPAA regulations and clinical confidentiality policies to safeguard patient information. Proficiency in Microsoft Office applications such as Word and Excel for documentation and reporting purposes. Experience in dental or medical office environments is a plus; familiarity with insurance prior authorization processes is highly valued. Join us in making a difference by ensuring seamless insurance verification that supports quality patient care! We are committed to fostering an inclusive environment where your skills can thrive as part of our dedicated healthcare team.

Pay:

$20.00 - $22.00 per hour

Benefits:

401(k) Paid time off

Work Location:

In person