Required Education and Experience High school graduate. One - two years medical business office experience or related field.

Additional Eligibility Qualifications Basic medical terminology. Experience with various types of insurance plans (HMO’s, PPO’s, etc.) Excellent organizational and problem-solving skills. Aptitude to retain detailed information. Ability to be multi-task oriented, to prioritize and to maintain production standards. Accurate typing rate of 40 wpm. Ability to operate the following equipment: computer, copier, fax, and 10-key calculator. Possess advanced skills in using telephone as a primary instrument for communicating and are knowledgeable with telephone etiquette. Must be able to assess a situation and decide best course of action. Professional appearance and manner required.

Summary/Objective
Insurance Verification Representative reviews electronic eligibility response tasks received daily. Updates insurance information on account as needed. Meets or exceeds production standards. Accesses information through use of billing system and interprets information. Verifies if referrals are required.

Essential Functions
Accurately enters insurance error information in the established database to be maintained for statistics for all staff members

Audits scanned image of insurance card for compliance. Meets or exceeds production standards. Edits any insurance mastering errors.

Communicates with staff any discrepancies with insurance plan types. Provides support to staff with questions concerning insurance.

Reviews electronic eligibility response tasks received daily. Updates insurance information on account as needed. Meets or exceeds production standards. Accesses information through use of billing system and interprets information. Verify if referrals are required.

Review and transfer open invoices to ensure all are filed with the appropriate insurance carrier, and that any self-pay is billed. Request any charge corrections as necessary.

Reviews insurance identity rejection tasks. Contacts patient to obtain valid insurance information. If no insurance, advise patients of their financial responsibilities. Requests payment upon resolution of inquiry. Refers complex problems to the appropriate area. Documents action taken in notes.