Insurance Specialist Part Time
Insurance Specialist Part Time
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Overview
Responsible for verifying eligibility of benefits and obtaining insurance authorizations for all patients that receive care in the Physical Medicine and Rehabilitation outpatient departments. Works with providers offices on authorizations and denials as applicable. Performs charge and chart audits to ensure accurate billing and documentation. Supports the Scheduling/Financial Specialists when assistance is needed.
Why UnityPoint Health
- Commitment to our Team For the third consecutive year were proud to be recognized as a Top 150 Place to Work in Healthcare by Beckers Healthcare for our commitment to our team members.
- Culture At UnityPoint Healthyou matter. Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing whats right for the people we serve.
- Benefits Our competitive Total Rewards program offers benefits options like 401K match paid time off and education assistance that align with your needs and priorities no matter what life stage youre in.
- Diversity Equity and Inclusion Commitment Were committed to ensuring you have a voice that is heard regardless of role race gender religion or sexual orientation.
- Development We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience.
- Community Involvement Be an essential part of our core purposeto improve the health of the people and communities we serve.
Hear more from our team members about why UnityPoint Health is a great place to work at .
Responsibilities
Complex Scheduling and Registration
- Schedules complex multidiscipline patient appointments.
- Monitors and completes accounts on multiple work queues in EPIC.
- Ensures patients have eligible and active insurance prior to scheduling and helps patients understand their coverage for services. Updates registration if coverage has changed and ensures account is accurate for correct and timely claims filing.
- Gathers billing information for patients with workers comp insurance (employer demographics responsible billing party billing address) and coordinates authorization for services.
Insurance Verification/Regulations
- Verifies eligibility and authorization needs of current and new patients for assigned departments.
- Maintains a working knowledge of relevant regulations affecting patients and the operation of our business.
- Assists in educating and acts as a resource to clinical and nonclinical staff related to coding and insurance regulations.
- Provides patient notification of insurance coverage and estimated responsibility which may include coordination with Priceline and counseling patient on process for prompt pay and financial assistance applications.
- Accurately enters required information into EPIC account notes.
PreAuthorizations
- Establishes effective rapport and works closely with clinical staff doctors offices patients and families to ensure that all patients have authorization for services.
- Initiates and coordinates prior authorization requests to third party payers and maintains a working knowledge of thirdparty payer guidelines. Follows up with thirdparty payers as necessary.
- Contacts patients and providers with authorizations or denials as applicable.
- Meets specified deadlines as required for continuity of ongoing patient care and patient satisfaction.
Accurate Billing
- Performs charge and documentation audits to ensure proper payment for assigned departments and compliance to insurance and government regulations. Correct charges and coding as needed.
- Runs revenue & usage reports to ensure timely billing and correct coding for patients served.
- Works with schedulers and clinical staff to improve processes and documentation to increase reimbursement and avoid denials.
Denials/Billing Issues
- Problem solves analyzes and collaborates with patient therapist central billing office revenue cycle department and insurance companies to identify and resolve billing and denial issues including sending appeals and troubleshooting and correcting claim or account errors.
- Documents denials and billing issues to identify processes that need improvement in order to maximize efficiency and ensure proper payment within the department(s).
- Monitors and completes accounts on multiple work queues in EPIC including referrals and denials.
- Handles next tier troubleshooting and escalations of billing and insurance concerns from patients scheduling & billing specialists or providers.
- Establishes and maintains accurate files using word processing and spreadsheet documents.
- Maintains designated filing and record keeping systems. Assists with preparation of reports graphs and statistical information related to billing/insurance/denials.
Qualifications
- High School/GED.
- Previous customer service experience.
- Minimum of 1year prior secretarial experience in medical environment.
- Requires knowledge of commercial and workers compensation insurance.
- Knowledge of medical terminology.
- Knowledge of medical billing and insurance.
- Strong problemsolving skills.
- Proficient in Microsoft office.
- Demonstrate a professional image in dealing with the public patients families payers and doctors offices.
Required Experience:
Unclear Seniority
Employment Type
Part-Time
