Medical Insurance Verifier

Job ID: 10-2022-210

JOB DESCRIPTION

Specialty Eye MDs is a large and comprehensive Ophthalmology practice in New Jersey. We are the recognized leader in vision care treating adults and children.

JOB TITLE: INSURANCE VERIFICATION CLERK

POSITION SUMMARY:

The INSURANCE VERIFICATION CLERK performs clerical functions for patient billing, including verification of insurance information and resolution of problems to ensure a clean billing process, follows-up on accounts that require further evaluation and works with others in a team environment.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Maintains patient demographic information and data collection systems.
• Verify insurance eligibility for both Medical and Vision insurances for upcoming appointments by utilizing online websites or by contacting the carriers directly.
• Review patient deductibles and/or copays and enter into the billing system and spreadsheets provided to the Front Desk department at all locations.
• Coordinate with Front Desk regarding scheduling errors.
• Assist Front Desk staff in understanding carrier websites and verification of eligibility.
• Enter insurance referrals as needed.
• Assist in obtaining Pre-certification for Procedures required by some Insurance carriers.
• Participates in development of organization procedures and update of forms and manuals.
• Answers questions from patients, clerical staff and insurance companies.
• Works in conjunction with the Front Desk to ensure clean billing.
• Participates in educational activities and attends monthly staff meetings.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Assists in development and communication of SOP for key areas to improve accuracy and understanding of processes.
• Performs miscellaneous job-related duties as assigned by Management.

QUALIFICATIONS & SKILLS:

• Minimum 1 year of relevant experience. High School or higher education.
• Strong knowledge of various Medical Insurances.
• Strong knowledge of administrative and clerical procedures.
• Proficient in computers, MS Office Suite and relevant software applications and practice management technology.
• Possession of strong problem solving skills and sound judgment.
• Ability to collaborate across departments and build effective relationships with internal and external customers to achieve goals.
• Knowledge of customer service principles and practices.
• Ability to achieve team goals while demonstrating organizational values and utilizing resources responsibly.
• Ability to be proactive and take initiative.
• Exhibit high level of quality through attention to detail and monitoring of work.
• Possession of strong organizational skills.
• Excellent verbal and written communication, as well as exceptional interpersonal communication skills.
• Ability to work independently on assigned tasks, as well as to accept direction on given assignments.
• Deals with confidential information and/or issues using discretion and judgment.

PREFERRED EXPERIENCE:

• Prior Insurance Verification experience in a medical office.
• Customer service.