Position Overview:

Ultimate Staffing is actively seeking an experienced Insurance Verification Specialist to join their client's team in Florida. The Insurance Verification Specialist, reporting to the Revenue Cycle Supervisor, is responsible for verifying insurance for clinic and outpatient surgery appointments. The specialist will also counsel patients regarding their financial cost share for procedures and collect payments prior to procedures. The ideal candidate will thrive in a team environment, demonstrate flexibility when accepting work, and possess a strong customer service focus to effectively interact with patients, doctors, staff, and management.

Responsibilities:

• Verify patient eligibility via payer websites or telephone to determine coverage of benefits and calculate patient responsibility for scheduled services.
• Add or update patient insurance primary and/or secondary insurance in EHR.
• Understand medical insurance, including deductibles, copay, and coinsurance, and interpret medical benefits for Medicare, Medicaid, and major commercial health insurance and secondary payers.
• Process provider referrals and prior authorization requests.
• Ensure complete and accurate information is maintained in patient accounts, including authorization or referral received from payer or Primary Care Physician.
• Familiarize with individual payer guidelines and authorization/referral requirements based on insurance plans; communicate with insurance companies via phone and/or website to provide any supporting clinical documentation needed to complete the authorization process.
• Perform general duties and other functions as required or assigned.
• Maintain strong people skills; be diplomatic, patient, flexible, and able to multi-task; be cross-trained on all functions within the Insurance Verification Department.
• Be mobile in an office setting, including sitting, standing, walking, and bending.
• Utilize working knowledge of Microsoft Suite, including Excel, Word, and Outlook.

Qualifications:

• Solid understanding of medical terminology and ICD-10 codes and Diagnosis preferred.
• Previous experience with verifying and interpreting medical benefits for Medicare, Medicaid, and major commercial health insurance and secondary payers required.
• Previous experience processing provider referrals and prior authorization requests.
• Strong customer service focus with the ability to effectively interact with patients, doctors, staff, and management.

Work Hours:

Monday to Friday, first shift.

Benefits:

Additional details regarding benefits will be provided during the interview process.

Compensation:

Pay ranges from $19 to $24 per hour, based on experience.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, Los Angeles County Fair Chance Ordinance, and San Francisco Fair Chance Ordinance.