Hybrid Insurance Verification Specialist presso KIDNEY SPECIALISTS OF SOUTHERN NEVADA

Description

Position Summary

The Insurance Verification Specialist is responsible for verifying patient insurance coverage, ensuring accurate billing, and securing necessary authorizations prior to services being rendered. This role plays a critical part in the revenue cycle by preventing delays in patient care and claim denials. 

Essential Job Functions:

• Verify insurance coverage and eligibility for new and existing patients.
• Obtain prior authorizations or referrals as required by insurance plans.
• Communicate with insurance companies to clarify coverage and benefits.
• Utilizes insurance verification websites to check for current insurance coverage for patients.
• Accurately enter insurance details into the electronic medical record (EMR) or practice management system.
• Convey and answer any questions a patient may have regarding their benefits.
• Collaborate with front office, billing, and clinical teams to ensure timely scheduling and accurate billing.
• Maintain up-to-date knowledge of insurance guidelines and policy changes.
• Follow-up on pending authorizations to avoid delays on care.
• Maintains patient accounts by obtaining, recording, and updating personal and financial information.
• Processes patient paperwork.
• Protects patients’ rights by maintaining confidentiality of medical, personal, and financial information.
• Maintains operations by following policies and procedures.
• Cross trains in all front office positions to cover as assigned.
• Additional duties as assigned

Qualifications

Minimum Requirements

• Must have at least a high school diploma.
• Minimum of three (3) years of prior insurance verification or medical billing (required).
• Must have exceptional written and verbal communication and organizational skills
• Strong knowledge of medical terminology, insurance plans (HMP, PPO, Medicare, Medicaid), and prior authorizations processes. 
• Excellent communication and customer service skills. 
• Experience with EMR or practice management software is a plus. 
• Bilingual in Spanish, preferred but not required.