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Insurance Verification Specialist

Altru Health System
Grand Forks, KSA
Full Time
Entry
Onsite
4 weeks ago
Insurance VerificationMedical TerminologyCustomer ServiceElectronic Medical RecordsMedicare Secondary Payer
Free

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Insurance VerificationMedical TerminologyCustomer Service
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Summary

  • The Insurance Verification Specialist supports financial clearance through accurate and timely verification of insurance and benefit information for patients at Altru Health System.

Essential Job Functions

  • Ensures and adheres to strict confidentiality when handling patient charts, records, and registration information.
  • Utilizes online systems, phone communication, and other resources to determine eligibility and benefits prior to the date of service.
  • Accurately identifies and assigns payer plans in the electronic medical record and notifies appropriate leaders of potential payer or RTE discrepancies.
  • Reviews Medicare accounts for completed and accurate Medicare Secondary Payer Questionnaire (MSPQ) to ensure correct filing order.
  • Communicates with patients, clinicians, front end staff, and translators to obtain any necessary additional or missing insurance or referral information.
  • Coordinates benefits by effectively determining primary and secondary liability when needed.
  • Alerts physician offices and patients to issues with verifying insurance or meeting referral requirements.
  • Holds proficient understanding of insurance terminology.
  • Assists in training new insurance verification staff and front end staff on insurance verification processes.

Education and Experience

  • Preferred: Associates Healthcare
  • Required: A minimum of 1 year Related Experience

Language Requirements

  • This position requires proficiency in reading, writing, and speaking English to ensure effective communication.

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