- Accurately verify patient insurance coverage, benefits, and eligibility using systems like AthenaHealth and payer portals.
- Obtain and track pre-authorizations for services when required by the payer.
- Identify primary and secondary insurance coverage to ensure proper coordination of benefits and avoid future claim denials.
- Maintain accurate and up-to-date documentation of insurance verification outcomes in the system, ensuring billing compliance.
- Collaborate with billing specialists and patients to resolve eligibility-related issues, claim holds, or denials.
- Maintain proprietary insurance-provider mapping database in collaboration with the Operations team.
- Notify patients of any discrepancies in coverage or issues with their insurance eligibility.
- Ensure patient insurance information is correctly recorded and maintained for accurate billing and reimbursement.
- Conduct follow-up on pending insurance verifications to prevent delays in billing or service delivery.
ZendeskEHR