Richmond, VA, United States, North America
Entry Level (Less than 2 years of Experience)
Insurance Verification Specialist
Compiles data and performs insurance verifications and pre authorizations prior to billing.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Implements the Company Mission Statement.
- Contacts insurance agencies regarding individual patient’s policies to verify coverage.
- Enters information into computer accurately.
- Prepares and compiles documentation as needed for proper determination.
- Gathers all documentation necessary for pre-authorization approvals
- Contacts patients, doctors and insurance companies by phone, mail, fax or email.
- Maintains communication with patient, sales person (both, inside or field) and account reps associated with each individual account.
- Assists Documentation Specialists in procuring all documentation necessary to process account claims, as needed.
- May be called upon to assist in other various aspects of the billing process, i.e. posting payments, working reports, etc.
- Participates in Improvement of Operational Performance (IOP) activities.
- Participates in traditional and e-learning programs.
COMPETENCY: To perform the job successfully, an individual should demonstrate the following competencies:
- Analytical - Uses intuition and experience to complement data.
- Design - Demonstrates attention to detail.
- Problem Solving - Gathers and analyzes information skillfully; Works well in group problem solving situations.
- Project Management - Completes projects on time and budget.
- Technical Skills - Assesses own strengths and weaknesses; Pursues training and development opportunities.
- Customer Service - Responds promptly to customer needs; Responds to requests for service and assistance; Meets commitments.
- Interpersonal - Maintains confidentiality; Listens to others without interrupting; Remains open to others' ideas and tries new things.
- Oral Communication - Listens and gets clarification.
- Team Work - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Contributes to building a positive team spirit.
- Written Communication - Able to read and interpret written information.
- Change Management - Prepares and supports those affected by change.
- Leadership - Exhibits confidence in self and others; Inspires respect and trust; Accepts feedback from others; Provides vision and inspiration to peers and subordinates.
- Managing People - Makes self available to staff; Improves processes, products and services.
- Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
- Business Acumen - Displays orientation to profitability.
- Cost Consciousness - Conserves organizational resources.
- Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences.
- Ethics - Works with integrity and ethically; Upholds organizational values.
- Organizational Support - Follows policies and procedures; Completes administrative tasks correctly and on time; Supports organization's goals and values.
- Adaptability - Adapts to changes in the work environment; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
- Attendance/Punctuality - Is consistently at work and on time.
- Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments.
- Initiative - Undertakes self-development activities; Looks for and takes advantage of opportunities; Asks for and offers help when needed.
- Innovation - Generates suggestions for improving work.
- Judgment - Exhibits sound and accurate judgment; Includes appropriate people in decision-making process.
- Motivation - Measures self against standard of excellence.
- Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently.
- Professionalism - Approaches others in a tactful manner; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
- Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
- Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity.
- Safety and Security - Observes safety and security procedures; Reports potentially unsafe conditions; Uses equipment and materials properly.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
To perform this job successfully, an individual should have knowledge of Word Processing software; Accounting software.
CERTIFICATES AND LICENSES:
No certifications needed
This job has no supervisory responsibilities.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually quiet.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Job keywords/tags: insurance medical health