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Established Ophthalmology practice, currently looking to hire an enthusiastic Insurance Verification Specialists for our Clinical and Surgical departments.

DEPARTMENT

Front Office Insurance Operations

REPORTS TO

Director of Operations

EFFECTIVE DATE

Immediately SUMMARY:

We are seeking a detail-oriented Insurance Verification Specialist to verify patient insurance eligibility, benefits, and coverage prior to appointments and procedures. The ideal candidate is organized, reliable, and comfortable working with insurance companies, patients, and healthcare teams.

DUTIES AND RESPONSIBILITIES

• Verify patient insurance eligibility and benefits.

Confirm coverage, deductibles, copays, coinsurance, and authorization requirements. Obtain and document accurate insurance information. Communicate coverage information to patients and staff. Follow up on insurance discrepancies and missing information. Maintain accurate and timely records in the electronic health record (EHR). Coordinate with billing, scheduling, and clinical teams as needed. Protect patient confidentiality and follow HIPAA requirements. Retrieve the appointment list of patients two to five days before their visit and performs insurance verification Verify whether the plan coverage is Primary or Secondary; HMO, PPO or Commercial Carrier Insurance Verify optical plan coverage including deductibles and copays Verify the out-of-network requirements/benefits for each patient Verify add-on patients and obtain appropriate information Maintain proper insurance verification documentation in the patient's medical record Review all insurance page fields for accuracy Communicate with insurance carriers for insurance verification and/or troubleshooting Obtain insurance referrals when necessary Input or correct any demographic, insurance information, referrals, or patient management into the practice management software Performs miscellaneous job-related duties as assigned Inform management of any pending issues which might delay ability to perform scheduled procedure. Knowledge of Diagnosis and billing procedures for ophthalmology and optometry Knowledge of clinical documentation, exam procedures and protocols Ensure confidentiality of all health information as required by Florida Statutes and HIPAA guidelines ensuring compliance.

QUALIFICATIONS

Post high school certification and undergrad courses preferred; at least 2 years of work experience that can be demonstrated to be applicable to the duties listed in the job description. Working knowledge of Microsoft Office Software Licensed/Certified in CPT codes and ICD 10 Knowledge of Medical / Ophthalmology / Optometry diagnosis Preferred previous Optometry work experience.

COMPETENCIES

Problem Solving

• -Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics. Oral Communication
• Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. Teamwork
• Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed. Strategic Thinking
• Develops strategies to achieve organizational goals; Understands organization's strengths & weaknesses; Analyzes market and competition; Identifies external threats and opportunities; Adapts strategy to changing conditions. Motivation
• Sets and achieves challenging goals; Demonstrates persistence and overcomes obstacles; Measures self against standard of excellence; Takes calculated risks to accomplish goals. Dependability
• Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan. Initiative
• Volunteers readily; Undertakes self-development activities; Seeks increased responsibilities; Takes independent actions and calculated risks; Looks for and takes advantage of opportunities; Asks for and offers help when needed.

BENEFITS

: Medical/Dental insurance Vision Coverage Benefits/Perks Retirement plan contribution and match Paid time off Professional development assistance

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Fast paced work environment, able to multi-task. The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or physical requirements. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Job Type:

Full-time Benefits:

401(k) 401(k) matching Dental insurance Employee discount Health insurance Life insurance Paid time off Vision insurance

Experience:

Insurance Verification:

2 years (Required)

Ophthalmology:

2 years (Required)

Optical:

2 years (Required)

License/Certification:

Medical Coding Certification (Required) Willingness to travel: 25% (Preferred)

Work Location:

In person