Insurance Verification Representative
New
V
Vail HealthHealthcare
Roles based outside of our primary office can sit in any of the following states: AZ, CO, CT, FL, GA, ID, IL, KS, MA, MD, MI, MN, NC, NJ, OH, OR, PA, SC, TN, TX, UT, VA, WA, and WI. Please only apply if you are able to live and work primarily in one of the states listed above., 8:00 AM – 4:30 PM MST; requires adherence to this time zone regardless of location.Full-TimeJunior
Salary20.3 - 24.19 USD per hour
Apply NowOpens the employer's application page
Job Details
- Experience
- At least one year of professional experience using Epic, specifically working with and verifying Physical Therapy and/or Occupational Therapy workflows, is strongly preferred. One year of customer service experience preferred.
- Required Skills
- Customer service
Requirements
- One year of customer service experience preferred.
- Insurance verification or healthcare experience preferred.
- At least one year of professional experience using Epic is strongly preferred.
- Epic experience should include working with and verifying Physical Therapy and/or Occupational Therapy workflows.
- A degree in healthcare administration or a related field is preferred.
Responsibilities
- Determine patient eligibility and benefits before scheduled appointments using online systems, phone communication, and other resources.
- Assign payer plan codes accurately in the electronic health record system.
- Verify medical necessity under CMS standards and communicate coverage and eligibility details to patients.
- Gather additional information from patients, physicians, clinicians, front-end staff, and translators.
- Identify and obtain missing patient demographic, insurance, or pre-authorization information.
- Determine primary and secondary liability when coordinating benefits.
- Obtain pre-certifications and pre-authorizations from third-party payers.
- Escalate complex cases and notify patients or physician offices about verification or eligibility issues.
- Communicate patient financial responsibility or coordinate with staff on payment and financial assistance options.
View Full Description & ApplyYou'll be redirected to the employer's site
