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Insurance Verification Specialist

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- Verify active insurance coverage for all scheduled patients before their appointments, ensure accuracy of plan details and patient eligibility.
- Check deductibles, co-pays, out-of-pocket maximums, and other coverage details to provide accurate information to the billing and clinical teams.
- Update the electronic health record system with verified insurance details and flag any issues for follow-up.
- Assist patients in updating their insurance information by guiding them through the process of contacting their insurance payor.
- Respond to patient inquiries regarding their coverage, eligibility, and benefits with clarity and professionalism.
- Educate patients on any necessary documents or information required to update or verify their coverage.
- Proactively reach out to patients ahead of scheduled visits to confirm insurance details and inform them of any anticipated co-pays or out-of-pocket expenses.
- Notify patients if insurance issues are identified and provide guidance on resolving these issues before the appointment to prevent delays.
- Work closely with the billing department to resolve any insurance-related billing issues and avoid claim denials.
- Communicate with front desk and clinical staff regarding any insurance updates or potential issues to ensure a smooth check-in and billing process.
- Maintain up-to-date knowledge of insurance policies, regulations, and any changes affecting patient coverage and eligibility.
- Accurately document insurance verification details, patient communications, and any updates in the EHR and billing systems.
- Track verification activities, report coverage trends, and identify common issues that may require process adjustments.
- Participate in periodic reviews of insurance verification protocols to enhance accuracy and efficiency.

Insurance Verifier verifies active insurance coverage for patients before appointments, ensures smooth billing processes, and assists patients with updating insurance information. This role involves working closely with patients and insurance companies to confirm coverage, resolve eligibility issues, and provide support for any insurance-related inquiries. The ideal candidate is detail-oriented, has excellent communication skills, and is familiar with health insurance procedures and regulations.

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