ATLANTICARE

_________________________

ROLE DESCRIPTION POSITION SUMMARY

AtlantiCare Physician Health Network is currently seeking an Insurance Verification Specialist. In this role you will be responsible for obtaining verification of all insurance benefits for patients and maintains/enters that information to reflect the most up-to-date coverage. Your duties may also involve obtaining pre-authorization for services, which requires effective phone communication skills. After verifying coverage, you will determine benefit level coverages and patient financial responsibility. Bilingual communication skills are a major plus. Attention to detail is key. This role requires the use of Cerner/Oracle revenue cycle and practice management modules and various additional applications. Verify insurance eligibility for patients and referrals by using various verification tools/apps or contacting the insurance carrier directly Update insurance/benefit information for existing patients Review schedules for upcoming patient appointments Enter new demographics into Cerner Review patient copays/deductibles and enter into the Cerner Coordinate with front end regarding registration/eligibility errors Enter insurance, referrals, authorizations and other related patient information into Cerner Answers questions from patients, physician practice staff and insurance companies Obtain pre-authorization for recommended services and procedures Determine and communicate patient financial responsibilities Communicate and help resolve eligibility and authorization related denials Manage worklists and queues and eligibility rejection reports Participate in educational activities and attends monthly staff meetings Assists in the development of communication and processes to improve overall departmental performance

QUALIFICATIONS EDUCATION

High school diploma or GED certificate

LICENSE/CERTIFICATION

EXPERIENCE:

WORK ENVIRONMENT

Potential for exposure to blood borne pathogens along with infectious diseases. (Refers to Blood Bourne Pathogen requirement) Essential functions of this position are listed on the Assessment and Evaluation Tool.

REPORTING RELATIONSHIP

The above statement reflect the general details considered necessary to describe the principle functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position. Qualifications

EDUCATION

High school diploma or GED certificate

LICENSE/CERTIFICATION

EXPERIENCE

1-2 years of relevant experience preferred; medical billing experience (preferred). General knowledge of CPT codes and basic medical terminology (preferred). Requires extensive computer/application use, phone communication skills and comfort with significant computer use and Bilingual ability (English/Spanish) preferred. Apply Now Job Identification 100261 Job Category Finance Job Schedule Full time Job Shift Day Pay Range $20.04 - $29.07 Holidays Required No Weekends Required No Hrs Per Week 37.5 Total Rewards at AtlantiCare At AtlantiCare, we believe in supporting the whole person. Our market-competitive Total Rewards package is designed to promote the physical, emotional, social, and financial well-being of our team members. We offer a comprehensive suite of benefits and resources, including: Generous Paid Time Off (PTO) Medical, Prescription Drug, Dental & Vision Insurance Retirement Plans with employer contributions Short-Term & Long-Term Disability Coverage Life & Accidental Death & Dismemberment Insurance Tuition Reimbursement to support your educational goals Flexible Spending Accounts (FSAs) for healthcare and dependent care Wellness Programs to help you thrive Voluntary Benefits , including Pet Insurance and more Benefits offerings may vary based on position and are subject to eligibility requirements. Join a team that values your well-being and invests in your future. Pay Transparency In order to support the Fair Compensation Strategy by the US Govt., HR Dept., clients are required to adhere to \"Pay Transparency Law\" in impacted states, which mandate employers to list salary ranges in job advertisements and promotions. AtlantiCare is an Equal Opportunity Employer Equal employment opportunity, including veterans and individuals with disabilities. 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Financial Clearance Specialist - Practice Management - EHT