Medical Insurance Verification Specialist Core Medical & Wellness Lyndhurst, NJ Job Details Full-time $24 - $25 an hour 10 hours ago Qualifications Medical coding Medical office experience Attention to detail Organizational skills Medical terminology Full Job Description Insurance Verification Specialist -

Pain Management Job Type:

Full-Time Hours:

40 hours per week

Schedule:

Monday-Friday, 9:00 AM-5:00

PM Wednesday:

Must be available to start as early as 6:30 AM when needed About the Position We are seeking an experienced and detail-oriented Insurance Verification Specialist to join our busy pain management practice. The ideal candidate will have strong knowledge of insurance verification and benefits, prior authorizations, pain management procedures and injections, CPT codes, and medical insurance requirements. Experience with auto insurance/PIP, arbitration, and NSA-related processes is highly preferred. The Insurance Verification Specialist will play an important role in making sure patients are properly verified and that insurance requirements are completed prior to scheduled procedures and injections. Responsibilities Verify patient insurance eligibility and benefits for pain management services. Verify coverage for procedures, injections, and other pain management services . Review benefits, deductibles, copays, coinsurance, and out-of-pocket responsibilities. Determine whether procedures require prior authorization, precertification, or referrals. Obtain and document required authorizations. Review the schedule and ensure upcoming procedures have been properly verified. Follow up with insurance companies regarding pending authorizations and coverage questions. Communicate insurance requirements and potential coverage issues to the appropriate office staff. Maintain accurate documentation of all insurance verification and authorization activity. Communicate with insurance representatives and document reference numbers and verification details. Work closely with providers, medical assistants, scheduling staff, and billing staff. Have a strong working knowledge of CPT codes , particularly CPT codes commonly used for pain management procedures and injections. Understand how CPT codes relate to insurance benefits and authorization requirements. Assist with insurance-related issues involving auto/PIP claims . Assist with auto arbitration , including gathering and organizing necessary insurance and claim information. Knowledge of NSA processes and related insurance requirements is preferred. Communicate with attorneys, adjusters, and insurance companies when necessary regarding patient claims. Assist with resolving insurance discrepancies before the patient's procedure. Follow up on denied, delayed, or partially covered services as needed. Maintain patient confidentiality and comply with HIPAA regulations. Perform additional insurance verification and administrative duties as assigned. Qualifications Previous experience in insurance verification, medical billing, authorizations, or a medical office required. Pain management experience strongly preferred. Strong knowledge of CPT codes and medical terminology. Experience verifying benefits for procedures and injections. Knowledge of prior authorizations and precertifications. Experience with PIP/auto insurance and arbitration preferred. Knowledge of NSA processes preferred. Strong attention to detail and organizational skills. Excellent communication and follow-up skills. Ability to work independently and manage multiple tasks and deadlines. Professional communication skills when dealing with insurance companies, attorneys, adjusters, patients, and medical staff. Ability to maintain accurate and detailed records. Must be dependable and able to work a full-time schedule. Schedule 40 hours per week

Monday-Friday:

9:00 AM-5:00

PM Wednesday:

May be required to start as early as 6:30 AM based on surgery/procedure center needs. Ideal Candidate The ideal candidate is someone who understands the insurance side of a pain management practice , can confidently verify benefits for procedures and injections, understands CPT codes and authorization requirements, and is comfortable working with auto/PIP claims, arbitration, attorneys, adjusters, and insurance companies . We are looking for someone who is organized, dependable, detail-oriented, and able to take ownership of the insurance verification process from verification through authorization and follow-up.

Pay:

$24.00 - $25.00 per hour

Work Location:

In person