Job Specification:
- Verify and validate patient insurance coverage and eligibility before services are provided, ensuring there are no billing surprises later.
- Coordinate with healthcare providers to ensure accurate submission of claims in line with insurance requirements.
- Work with insurance companies to resolve discrepancies or denials related to patient coverage and claims.
- Educate patients about their insurance benefits, co-pays, deductibles, and any potential out-of-pocket costs.
- Maintain detailed records of insurance communications, including coverage verification and claim submission details.
- Assist patients and the healthcare team in resolving insurance-related issues and ensuring smooth processing.
Requirements and skills:
- In-depth knowledge of health insurance plans, billing procedures, and payer requirements.
- Strong understanding of insurance verification processes and claim submissions.
- Good problem-solving skills and attention to detail.
- Excellent communication and customer service skills, particularly in dealing with patients and insurers.
- Proficiency in insurance management systems and medical billing software.
- Prior experience in insurance verification or claims management is preferred.