Insurance Verification Specialist

Job Summary

Responsible for verifying insurance coverage and eligibility of all patients' accessing services. Maintains confidentiality, professionalism, and ethics while assuring verification accuracy; pertaining to insurance coverage, demographics, and responsible party.

Job Responsibilities

• Verifies coverage and eligibility in real-time for multiple departments throughout the organization.
• Verifies insurance coverage presented by the patients.
• Complete tasks that fall to the patient, claim edits, and account work queues.
• Communicates effectively with the community, professionals, insurance companies, and external agencies.
• Supports Case Management Staff for current patient issues.
• Communicates closely with financial advocates to resolve issues that require patient input.
• Resolves issues related to eligibility and coverage identified by billing staff to ensure claim payments.
• Participates in maintaining the payer database in EPIC.
• Supplies educators with examples of coverage discrepancies used to assist in the continued training of Access staff.
• Problem solves and troubleshoots system errors and reporting issues and/or routes to system administrators.
• Assists with special projects and duties as assigned.
• Performs all functions related to registration/admitting via computer.

Qualifications

• High school diploma, General Equivalency Diploma (GED) or higher required upon hire
• No experience required
• No licensure/certification/registration required

Skills and Attributes

• Requires critical thinking skills and decisive judgment.
• Works under minimal supervision.
• Must be able to work in a stressful environment and take appropriate action.
• Knowledge in Medical Terminology and Medical Insurance.

Physical Demands

• Standing: Occasionally
• Walking: Occasionally
• Sitting: Frequently
• Lifting 0-25 lbs: Rarely
• Lifting 25-75 lbs: Never
• Lifting over 75 lbs: Never
• Carrying 0-25 lbs: Rarely
• Carrying 25-75 lbs: Never
• Carrying over 75 lbs: Never
• Pushing/Pulling 0-25 lbs: Rarely
• Pushing/Pulling 25-75 lbs: Never
• Pushing/Pulling over 75 lbs: Never
• Climbing: Rarely
• Bending/Stooping: Rarely
• Kneeling: Rarely
• Crouching/Crawling: Rarely
• Reaching: Occasionally
• Talking: Frequently
• Hearing: Occasionally
• Repetitive Foot/Leg Movements: Never
• Repetitive Hand/Arm Movements: Frequently
• Keyboard Data Entry: Frequently
• Running: Never
• Vision: Depth Perception: Frequently
• Vision: Distinguish Color: Frequently
• Vision: Seeing Far: Frequently
• Vision: Seeing Near: Frequently

Owensboro Health Core Commitments

INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers.

RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community.

TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future.

INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health.

SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do.

EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service.