Senior Executive

JOB DESCRIPTION:     Insurance Verification Specialist/Eligibility and Verification Specialist -Senior Executive - Operations

JOB SUMMARY:  The primary function of the Insurance Verification Specialist is to contact carrier groups to obtain eligibility information ensuring that the most updated verification is entered into the practice management software. Develops and maintains effective relationships with the patients ensuring all patient demographic and insurance information is obtained. 

REQUIRED EDUCATION/EXPERIENCE: Graduate in any stream; customer service; must be computer literate; have multi-tasking skills, excellent organizational skills, verbal and written communication skills; team player. 

YEARS OF EXPERIENCE:

• 2-5 Years for A2 Band

POSITION RELATIONSHIPS:

• Reports directly to the Assistant Manager

JOB RESPONSIBILITIES:

• Responsible for effective and efficient verification of all patients’ benefits before their appointment. 
• Responsible for answering incoming calls from other providers, recipients, and carrier groups in relation to insurance coverage. 
• Research eligibility information online with various insurance carriers. 
• Responsible for acting as a liaison between patients, healthcare providers, and insurance carriers to ensure all proper measures are taken and information is collected. 
• Ensures all patient questions are answered and issues are resolved timely by utilizing the appropriate resources. 
• Responsible for obtaining all referrals and authorizations for procedures and services, as required. 
• Other duties as assigned by the Lead Asst. Managers/Managers.

PROFESSIONAL:

• Recognize and respect cultural diversity. 
• Adapt communication to an individual’s ability to understand. • Use medical terminology appropriately. 
• Respond to communications received within a reasonable time frame. 
• Project a professional manner and image. 
• Adhere to ethical principles. 
• Demonstrate initiative and responsibility. 
• Work as a team member. 
• Efficient Time Management. 
• Prioritize and perform multiple tasks. 
• Adapt to change, including new hours of operation and methodology. 
• Attend functional team meetings and mandatory in-service education. 
• Maintain proper observation and adherence to company policies and procedures. 

KNOWLEDGE, SKILLS, AND EXPERIENCE:

• Good organizational skills and the ability to multi-task 
• Ability to operate basic office equipment, answer multi-line telephones, and have a strong computer background. 
• Establish and maintain effective working relationships with patients, insurance companies, and staff. 
• Good written and oral communications. 
• Knowledge and skills in working with computerized billing systems including practice management software and EMR. 
• Must adhere to all HIPAA guidelines and regulations. 
• Knowledge of medical insurance and authorization processes. 
• Some medical terminology and experience working in a healthcare or insurance environment. 

LEGAL and COMPLIANCE:

• Maintain patient and company confidentiality. 
• Practice within the scope of education, training, and personal capabilities. 
• Document company documents (hard copy and electronic) accurately. 
• Use appropriate guidelines for releasing information. 
• Maintain awareness of US federal and US state health care legislation and regulations, PHI, HIPAA

WORKING HOURS:

• 40 hours per week as Full-time employee
• Shift time: 7:30 PM IST - 4:30 AM IST
• Weekends Off

TELECOMMUTER/INTERNET REQUIREMENT:

• High Speed internet connection at home, must be broadband with minimum of 100 MBPS Speed or above
• Must understand and adhere with telecommuter policy
• Must have power backup at to mitigate power outage