Job description

At GenesisCare we want to hear from people who are as passionate as we are about innovation and working together to drive better life outcomes for patients around the world.

Insurance Verification Specialist

Sarasota, FL

Do your life’s best work!

The Insurance Verification Specialist performs clerical functions for patient billing, including verification of insurance information and resolution of problems to ensure a clean billing process. This position will also follow up on accounts that require further evaluation. The Insurance Verification Specialist will work with others in a team environment.

What you’ll do:

• Verifies detailed insurance benefits, medical necessity, and authorization/referral guidelines, consistently prioritizing and following the established verification process
• Read and interpret insurance Explanations of Benefits (EOB)/Remittance Advice (RA) with understanding and take appropriate steps to resolve issues.
• Obtain patient responsibility, research payer coverage criteria and any required prior authorization requirements
• Verify all information obtained is correctly documented in the patient's account, in the correct format.
• Contact client to obtain the correct insurance information
• Obtain pre-authorizations as needed
• Communicate with insurance providers via phone and electronically via web portals to validate patient benefits, check authorization requirements, and review authorization status.
• Utilize online systems, phone communication, and other resources to verify eligibility and benefits, determine extent of coverage, and secure pre-authorizations before scheduled appointment date.
• Calculate patient responsible balances based on coverage findings and documents in the patient records in CRM (Salesforce).
• Communicate insurance findings with relevant parties internally and externally
• Read and interpret insurance Explanations of Benefits (EOB)/Remittance Advice (RA) with understanding and takes appropriate steps to resolve issues.
• Obtain patient responsibility, research payer coverage criteria and any required prior authorization requirements
• Prepare and send prior authorizations to insurance when required
• Address incoming billing questions from patients and/or internal team members.
• Thoroughly documents correspondence with insurance, clients, patients, and/or insurance in the patient records.
• Identify important patient and demographic information that are missing and update information to avoid claim processing issues with the insurer.
• Send clinical documentation to the insurance company for review and approval.
• Follow up with insurance companies to ensure documentation has been received and prior authorization and/or gap exception is in process.
• Work cooperatively with others.
• Work as part of a team and support team decisions.
• Communicate effectively, both verbally and in writing.
• Adapt to changes in requirements/priorities for daily and specialized tasks
• Other duties as assigned

Who you are:

• Minimum of 1 year of relevant experience and/or training, or equivalent combination of education and experience.
• Prior Insurance Verification experience in a medical office preferred
• Basic Life Support Certification required.
• Strong knowledge of administrative and clerical procedures.
• Proficient in computers and relevant software applications and practice management technology.
• 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 and monitoring of work.
• Possession of strong organizational skills.
• Excellent verbal and written communication, as well as exceptional interpersonal communication skills.
• Ability to work independently on assigned tasks, as well as to accept direction on given assignments.
• Deals with confidential information and/or issues using discretion and judgment.

What’s in it for you

• Own your development, learn every day and be part of GenesisCare’s rapid growth
• Internal career development opportunities globally in USA, UK, Spain & AU
• Thriving close-knit culture and communities and supportive environment with encouragement to live your highest potential
• Ongoing opportunities for professional development to keep up to date with current clinical practices in a rapidly developing global organisation
• A rewarding purpose-led organisation that provides positive outcomes to patients everyday
• The opportunity to work for one of the most influential healthcare providers pioneering the way forward in innovation for cancer treatments & heart disease
• Fast paced, high performing & agile working culture with lots of change due to our rapid growth
• All employees and their family members have access to free confidential support that is completely external to GenesisCare including financial, nutritional and wellbeing coaching, legal advice & counselling
• Learn and grow with our award-winning development programs
• Free access to thousands of LinkedIn training courses

Who we are:

We are 6000+ highly trained healthcare professionals and support staff across the United States, Australia, the U.K, Spain and China, designing cancer and heart disease treatments to help patients achieve the best possible life outcomes.

Global care

Across the world, we have more than 580+ centres to help us bring the right care to our patients. Every year our team sees more than 1.4 million patients globally across our Oncology, Cardiology & Sleep Medicine Centres.

People centricity is at the heart of what we do and we pride ourselves on making our people a priority, whether that be a patient or an employee. We aim to build culture of ‘care’ that is patient focused, and performance driven. Our people promise is “do your life’s best work, by always growing, having a profound human impact and making great things happen together.” If you’d like to truly make a difference, join us at GenesisCare!

GenesisCare is an Equal Opportunity Employer.

Job Type: Full-time

Pay: $20.00 - $24.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday
• No weekends

Ability to commute/relocate:

• Sarasota, FL: Reliably commute or planning to relocate before starting work (Preferred)

Experience:

• Insurance verification: 1 year (Preferred)

Work Location: In person

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