Insurance Verification Specialist (Remote)

Position: Insurance Verification Specialist (Remote)
Department: Insurance Verification
Schedule: Full Time
POSITION SUMMARY:
The Inpatient Verification Specialist role belongs to the Revenue Cycle Patient Access team and is responsible for coordinating all financial clearance activities by navigating all referral, precertification, and/or authorization requirements as outlined in payer-specific guidelines and regulations. The role plays an important dual role by helping to coordinate patient access to care while maximizing BMC hospital reimbursement.
This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit's performance expectations. This position reports to the Patient Access Supervisor and requires interaction and collaboration with important stakeholders in the financial clearance process including but not limited to insurance company representatives, patients, physicians, Boston Medical Center (BMC) practice staff, case management and inpatient financial counselors.
JOB REQUIREMENTS
EDUCATION:

• High School Diploma or equivalent required, Associates degree or higher preferred.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

• Case manager and/or coding certification desirable

EXPERIENCE:

• 4-5 years medical billing/denials/coding/and/or inpatient admitting experience desirable

KNOWLEDGE AND SKILLS:

• Displays a deep understanding of Revenue Cycle processes and applies knowledge to meet and maintain productivity standards as outlined by Management. IND123
• General knowledge of healthcare terminology and CPT-ICD10 codes.
• Must be comfortable with ambiguity, exhibit good decision making and judgment capabilities, attention to detail.
• Requires excellent verbal communication skills, and the ability to work in a complex environment with varying points of view.
• Knowledge of and experience within Epic is preferred.
• Demonstrates technical proficiency within assigned Epic work queues and applicable ancillary systems, including but not limited to: ADT/Prelude/Grand Central, HB & PB Resolute.
• Complete understanding of insurance is preferred.
• Demonstrates proficiency in Microsoft Suite applications, specifically Excel, Word, and Outlook. Displays a thorough knowledge of various sections within the work unit in order to provide assistance and back-up coverage as directed.

Req id: 29742