Healthcare Insurance Claims Specialist
hace 16 horas
This is a remote position in the healthcare industry. The role requires ensuring accurate and complete insurance coverage information for patients, verifying benefits, securing authorizations, and resolving coverage issues to facilitate timely payment for services rendered. The specialist will work closely with clinical, billing, and scheduling teams to resolve discrepancies or coverage issues, while maintaining detailed records of verification and authorization activities.
Responsibilities- Verify patient insurance eligibility and benefits through online portals, phone calls, or electronic systems
- Identify coverage limitations, deductibles, co-pays, and out-of-pocket responsibilities
- Obtain pre-certifications and prior authorizations for scheduled procedures or treatments
- Track and follow up on pending authorizations to avoid delays in patient care
- Inform patients of their insurance coverage, out-of-pocket costs, and any issues with their policy
- Education: High school diploma or equivalent; post-secondary education in healthcare administration is preferred
- Experience: Previous experience in insurance verification, billing, or a related healthcare field is advantageous
- Familiarity with medical terminology and coding (CPT, ICD-10) is beneficial
- Problem-solving and critical-thinking skills
- Time management and organizational skills
- Team-oriented mindset with a customer-focused approach
We are a healthcare organization dedicated to providing high-quality patient care and services. Our team is passionate about delivering exceptional patient experiences, and we strive to create a positive and supportive work environment.
The estimated salary range for this position is $45,000 - $65,000 per year, depending on qualifications and experience. This is a full-time position working 40 hours per week, Monday through Friday, with 1 hour unpaid break.
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