Insurance Verification Specialist Details

Insurance Verification Specialist

USPI - Portland, OR

Employment Type : Full-Time

This position exists to identify patient’s In and Out-of-network benefits and subsequent out-of-pocket expense prior to services being performed at the center.

Obtains insurance information. Confirms with insurance company that we have the correct billing information for the patients as well as correct claims address.

Verifies that authorization has been obtained for the date of surgery by the doctor’s office, and follows-up with doctor’s office if authorization has not been obtained. Obtains authorizations if needed.

Works with Surgeons office to obtain additional information or clarify. If information needs to be corrected, insurance verifier corrects and prints new forms.

Informs Business Office Manager or Administrator of any cases that may not be able to be done at the facility due to the insurance coverage and seeks approval or cancellation.

Verify all information obtained is correctly documented in the patients account, in the correct format.

Calculate patient responsibility according to their benefits and our contract with that particular insurance company. Mail quote letter to patient, file copy in patients chart. Call patient, confirm the information we have for them is correct. Inform patient of the amount due and that it is due on or before DOS. Explain our billing policies if needed to the patient.

Cross-train for front desk to provide break and lunch coverage.

Other duties as assigned by the Business Office Manager.

Required Skills:

• Skill in computer applications and use of calculator.
• Ability to perform mathematical computations and compute ratios and percentages.
• Knowledge of word processing programs.
• Ability to examine documents for accuracy and completeness.
• Ability to prepare records in accordance with detailed instructions.
• Ability to communicate clearly.
• Ability to work efficiently and productively.
• Ability to maintain confidentiality of sensitive information.
• Skill in establishing and maintaining effective working relationships with other employees, patients, clients, insurance organizations, and the public.
• Ability to work independently; manage multiple practices and multiple priorities, and to work swiftly but accurately.