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Insurance Verification Coordinator I at Spectraforce Technologies

Spectraforce Technologies Anywhere

Job Description

Position Title: Insurance Verification Coordinator I
Work Location: Remote
Assignment Duration: 3 Months (Possibility to extend or convert)
Work Schedule: 12-9 EST
Work Arrangement: Remote
Position Summary: Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits
Background & Context:

  • project ascend

Key Responsibilities:

  • Obtain and verify insurance eligibility for services provided and document complete information in system

  • Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies

  • Collect any clinical information such as lab values, diagnosis codes, etc.

  • Determine patient's financial responsibilities as stated by insurance

  • Configure coordination of benefits information on every referral

  • Ensure assignment of benefits are obtained and on file for Medicare claims

  • Bill insurance companies for therapies provided

  • Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures

  • Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs

  • Handle inbound calls from patients, physician offices, and/or insurance companies

  • Resolve claim rejections for eligibility, coverage, and other issues

Qualification & Experience:

  • Education/Certification: Required: High school diploma

  • Education/Certification: Preferred: NA

  • Licensure: Required: NA

  • Licensure: Preferred:

  • Years of experience required: 1 + years of experience

  • Disqualifiers: NA

  • Additional qualities to look for: Proficient in Microsoft Office, experience/backgrounds that do well in this role- Managed Care, Pharmacy, Medical terminology, Physician office experience, Customer Service, Call Center

  • Top 3 must-have hard skills stack-ranked by importance

    • 1 Managed Care

    • 2 Customer Service

    • 3 Call Center

Position is offered by a no fee agency.

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