JOB SUMMARY:

The Insurance Representative is responsible for clerical functions that include answering incoming calls and emails from patients regarding their insurance needs. The Insurance Verification Assistant will work within the policies and processes as they are being performed across the entire organization.

DUTIES INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING:

DUTIES AND RESPONSIBILITIES:

• Familiarization with insurance carriers that APC is contracted with.
• Insurance Verification knowledge
• Ensure accurate, compliant, and timely response to patients to ensure optimal customer service.
• Answer multi-line phone calls and send messages to the appropriate departments.
• Place phone calls to patients, patient’s family/significant other, insurance companies, and facility personnel in an attempt to acquire information necessary to verify.
• Maintains patient demographic information and data collection systems.
• Identifies emergent patient situations based on caller information and relays to appropriate party.
• Assist front end staff and call center staff in understanding carrier websites and verification of eligibility.
• Review patient deductibles and/or copay with front end & billing/coding staff
• Answers questions from patients, clerical staff and insurance companies.
• Performs miscellaneous job-related duties as assigned.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations; adheres to APC policies and procedures. ?

QUALIFICATIONS:

• High school diploma and a minimum of 1 year of relevant experience and/or training, or equivalent combination of education and experience. Experience must include understanding payer eligibility electronic returns, and the ability to differentiate between insurance plans, copay, deductible, and coinsurance.
• Possession of strong problem solving skills and sound judgment.
• Ability to collaborate across departments and build effective relationships with internal and external customers to achieve goals.
• Knowledge of customer service principles and practices.
• Ability to achieve team goals while demonstrating organizational values and utilizing resources responsibly.
• Ability to be proactive and take initiative.
• Exhibit high level of quality through attention to detail, accuracy, and monitoring of work.
• Possession of strong organizational skills.
• Excellent verbal and written communication, as well as exceptional interpersonal communication skills.

WORK RELATIONSHIPS:

Direct Supervision: Director of Revenue Cycle

WORKING CONDITIONS:

Environmental Conditions:

• Medical Office environment

Physical Conditions:

• Must be able to work as scheduled
• Must be able to sit and/or stand for prolonged period of time
• Duties involve moving materials, weighing up to 30 lbs.
• Required eye-hand coordination and manual dexterity sufficient to operate office equipment, etc.