Insurance Verification Specialist

Company: VCU Health System (Medical College of Virginia)
Facility: VCU Health System at Richmond
Department: 8008 Insurance Verification

Ensure the accuracy and completeness of demographic, insurance plan and visit level data for patients scheduled for an upcoming outpatient appointment, or based on a change to the registration and/or visit, ensuring data elements required for patient billing and insurance claim submission are satisfied without additional confirmation or data entry required by the front desk staff upon arrival of the patient for the scheduled visit. Successful performance of job duties will directly impact health system goals to reduce registration responsibilities of schedulers and front desk staff, reduce insurance denials resulting from registration errors, and reduce insurance denials resulting from failure to obtain referral/authorization.

Level and type of experience REQUIRED

Analytical skills and experience to determine if complete, accurate and timely patient registration (demographic, insurance plan and visit level) information is available within the account of a patient scheduled for an outpatient service.

Problem solving skills and experience to determine when appropriate secure and apply addition/revision of patient, guarantor, visit or third party payer data ensuring accurate patient billing and insurance claim submission for scheduled service.

Excellent customer service/communication skills to interact professionally with patients, insurance representatives, outpatient clinic staff, billing office staff, and medical center management.

Ability to interpret and apply a variety of instructions furnished in written and verbal form with limited standardization.

Ability to work as a team member, as well as independently with minimal supervision.

Ability to work productively in high volume environment with strict deadlines required to reach goals.

Education/training REQUIRED:

- High school diploma or general education degree (GED). /FONT Full time 1: Days