Insurance Verification Specialist

Employment Type

: Full-Time

Industry

: Financial Services - Insurance



Digestive Health Associates of Texas, P.A. (DHAT), is a large Gastroenterology group consisting of over 80 physicians with over 40 locations throughout the Dallas/Ft Worth area. We provide cost-effective, community-based health care services supporting the full spectrum of an individual's digestive healthcare, with access and quality patient care unsurpassed in this area.

COMPENSATION & BENEFITS:

Digestive Health Management is anEqual Employment Opportunityemployer. We value our employees' time and efforts. Our commitment to your success is enhanced by our competitive compensation package and future growth opportunities within the company. For full-time employees, we offer an extensive benefits package including medical, dental, vision benefits, basic and optional life insurance, short and long term disability, flexible spending accounts, health savings account, 401(k) with company match and discretionary profit sharing, paid holidays, vacation, sick time, a competitive salary and an enjoyable work environment.

ABOUT THIS POSITION:

This position is responsible for verification of benefits, authorizations and collection of cost sharing for a busy central scheduling team. This individual will work closely with insurance companies to ensure the verification of benefits are correct and up to date before the procedure is performed.

Primary Job Duties:

The Essential Job Functions are:

  • Verification of insurance benefits utilizing website, fax and phone
  • Requesting, verifying, and entering referrals/authorizations inside of eCliniclaWorks
  • Creating cost estimate for patient cost share
  • Notifying patient and collecting cost sharing amounts prior to procedure
  • Perform daily end of day to ensure balancing
  • Knowledge of plan types HMO, PPO, POS, EPO
  • Understanding of Medicare and Medicare Replacement Plans
  • Knowledge of health plan portals/websites
  • Promotes professional image by adhering to the established dress code
  • Meet productivity standards to ensure benefits are completed in a timely manner
  • Timely completion of all compliance training and testing
  • All other duties as assigned

Qualifications & Certifications:

  • Minimum two years' experience in medical insurance verification
  • Ability to effectively communicate benefits and any verification issues
  • Ability to exercise discretion on sensitive and confidential matters
  • Ability to communicate effectively on the phone, in writing, and via email
  • Ability to work in a team environment

Responsibilities related to company mission, culture and engagement:

  • Actively participate in achieving the company's Mission, that being to optimize the health of our patients and community by providing compassionate, state of the art care to adults and children with digestive and liver diseases
  • Adhere to the company's Code of Conduct, to conduct business with honesty, integrity, and in an appropriate manner for services provided, while ensuring that its business arrangements comply with relevant state and federal statutes and regulations
  • Consistently work on ways to engage our patients, improve their care experience and maintain strong relationships with referring physician offices and other referral sources
  • Create an environment of trust and healthy working relationships
  • Ability to adapt to changing healthcare environment and lead by example
  • Exemplify a 'can do' attitude and commitment to excellence

Mental/Physical Requirements:

  • Ability to work well under pressure with diverse groups of professionals and physicians
  • Requires reasoning ability and good independent judgment
  • Must demonstrate sensitivity to cultural differences within team and community
  • May require working under stressful conditions and irregular hours
  • May require working with frequent interruptions
  • Work may involve prolonged periods of sitting, standing, lifting, bending, reaching and the ability to push or pull items weighing 30 pounds or less
  • Required to operate computer keyboard, mouse, and monitor



* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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