Insurance Verification Specialist, Facility & Revenue Cycle
Overview
You will own insurance verification for surgical procedures at a growing healthcare management company, ensuring financial clearance for 500+ monthly cases. You'll work with EMR systems and ICD-10 codes, collaborating with physicians, billing, and coding teams. This remote role starts with 30-90 days in-person training in Houston, then offers full-time flexibility. You'll resolve coverage issues, calculate patient costs, and secure accounts before surgery, directly impacting revenue cycle efficiency.
What You'll Do9
- 1Verify patient insurance coverage and benefits through online portals, phone calls, and other resources, ensuring accuracy for CPT and ICD-10 codes.
- 2Resolve coverage issues promptly and update patient EMR with benefits, co-pays, and deductibles.
- 3Serve as liaison between patients, facilities, and physicians to secure financial clearance before surgery date.
- 4Identify patient accounts by payer type: self-pay, PPO, HMO, personal injury, or workmen’s compensation.
- 5Calculate patient co-pay and estimated co-insurance based on payer contracts, documenting responsibilities.
- 6Collaborate with billing and coding departments to ensure correct claims processing and documentation.
- 7Create financial arrangements with management when patients cannot complete payment.
- 8Respond to inquiries regarding patient accounts with accurate information, maintaining professionalism.
- 9Complete high-quality work while meeting productivity standards and performing related duties.
Requirements9
- 11+ year of revenue cycle experience.
- 21+ year of insurance verification in a hospital or ASC setting.
- 3High School Diploma or GED.
- 4Broad knowledge of HIPAA, federal and state regulations.
- 5Working knowledge of in-network and out-of-network insurance, prior authorization, and patient responsibility.
- 6Strong knowledge of managed care, medical terminology, CPT coding, and ICD-10.
- 7Proficiency with Microsoft Office (Excel, Word) and basic computer functions.
- 8Ability to work independently and in a team, with critical thinking and problem-solving skills.
- 9Excellent verbal and written communication for patient experience.
Salary Insight
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