Overview

Reimbursement Specialist - Insurance Verification (UTMC Program)Help Others, Make a Difference, Save a Life.Do you want to make a difference in people's lives every day?Or help people navigate the tough spots in their life?And do it all while working where your hard work is appreciated?You have a lot of choices in where you work make the decision to work where you are valued!Join the McNabb Center Team as the Reimbursement Specialist - Insurance Verification (UTMC Program) today!The Reimbursement Specialist - Insurance Verification (UTMC Program)JOB SUMMARYThe purpose of the Reimbursement Insurance Verification Specialist is to obtain and verify a client's commercial insurance coverage and to ensure procedures are covered by an individual's insurance.Specialist will be responsible for entering data in an accurate manner and updating client benefit information in the organization's billing system and verifying that existing information is accurate.The Specialist will perform a variety of auditing and resolution-centered activities, answering pertinent questions about coverage to internal and external sources, identifying insurance errors, and recommending solutions.Will be required to work regular office hours at the designated facility.JOB DESCRIPTIONEmployees in this job complete and oversee a variety of professional assignments to evaluate, review, enter, monitor, and update client insurance and billing information.JOB DUTIES/RESPONSIBILITIESNOTE: The job duties listed are typical duties of the work performed. Not all duties assigned to every position are included, nor is it expected that all positions will be assigned to every duty.Reviews the center's Commercial Notification Forms and returns an Insurance Verification Forms to the requesting staff within designated program timeframe.Verifies insurance information is up to date for the next day's client roster and updates any applicable pop-ups in the systemFor new clients, gives contact information, obtain client photo, updates the EMR with correct information and ensures the appropriate intake packet paperwork has been signed and verified to ensure clients understanding of policies.Prepares and updates the designated facility facesheets with insurance issues, patient responsibilities, outstanding balances, and any non-payment status changes for the next day and places them in HIPAA compliant blue folders for the appropriate providers.Analyzes designated eligibility reports on a daily basis.Communicates with and advises Insurance Verification Team Leader of all problems related to insurance verification.Advises other departments of updated or new insurance information as needed.Adheres to all policies and procedures related to compliance with all federal and state billing regulations.Communicates with billing representatives regarding any insurance issues that may arise.Review and update the Non-Payment status documents for both Med appointments and Therapy appointmentsMaintains a positive and professional attitude.Reads all emails and responds accordingly in a timely manner.Listens to all voicemails and responds accordingly in a timely manner.Works with members of various teams and/or departments on identifying process improvements.Possess flexibility to work overtime as dictated by department/organization needs.Communicates with clients regarding any benefit and/or billing questions they may have.Performs specified client benefit duties to ensure all required information is obtained for insurance verification, billing, and claims follow-up.Collects all client responsibility balances via cash, check, money order or credit card and issues receipts for payments.Assists in determining proper courses of action for successful resolution to insurance issues.Completes all program related paperwork required for reporting purposes.Possesses problem-solving skills to research and resolve discrepancies, denials, appeals, collections.Reviews patient bills for accuracy and completenes