Medical Insurance Verification Spealist

As a Verification Specialist, you will tackle a wide variety of interesting challenges, and uncover key insights that will drive positive outcomes for our patients.

Manhattan Restorative Health Sciences (MRHS) is New York?s leading group of award-winning medical centers specializing in advanced `body and mind? treatment plans and the development of related clinical research. MHRS employs a range of nationally renowned physicians and specialists to perform minimally-invasive procedures for our patients, including Pain Management, Advanced Interventional Treatments, Regenerative Medicine, and Integrative Wellness Therapies. We focus on the complex interplay between mental and physical symptoms, developing innovative treatment plans that promote longevity and offer our patients superior restorative health outcomes.

Responsibilities:

? Verification and pre-authorization of major medical insurances, workman's comp, and no-fault cases.
? Obtains proper insurance information, insurance cards, and identification.
? Update folders and patients charts with detailed and accurate information including In and Out of Network coverage.
? Practices confidentiality and privacy protocols in accordance with Office policies and HIPAA requirements.
? Coordinates with authorization and billing departments to ensure accuracy and efficiency with all related processes.
? Can identify all appointments and procedures for assigned departments that require authorization by monitoring the schedules, system reports, and dashboards.
? Can identify the referral and authorization requirements of the patients' insurance plans by using various on-line resources according to department workflows.
? Can verify insurance eligibility and benefits, and updates the patient's insurance information as necessary.
? Can complete referrals and prior authorizations in a timely manner according to department guidelines and workflows.
? Can ensure that appropriate and accurate information is entered into the patient account.
? Can respond timely and collaborates effectively with the Reimbursement Department teams to limit denials and ensure proper reimbursement.
? Can collaborate with team members to meet department deadlines and benchmarks.

Requirements: ? 2+ years experience with medical verifications and authorizations ? Knowledge of insurance carrier guidelines, clinical policies, and state guidelines pertaining to referrals and prior authorization. ? Workman's comp, no-fault, and major medical insurance experience required. ? Demonstrate complete system knowledge, ability to run reports document and manage referrals and authorizations, move correspondence, resolve eligibility and authorization hold, and other system tasks within the user's security access. ? Demonstrate the ability to request, prepare, and recognize the documentation required to support the medical necessity for the service being authorized. ? Demonstrate the ability to use the electronic tools and systems available to organize and process the daily work. ? Possess excellent interpersonal skills, outgoing and personable. ? Ability to thrive in a fast-paced environment. ? Excellent written and verbal communication skills. ? Methodical and detail-oriented ? Possess pleasant and personable telephone demeanor. ? Well-spoken and written English.

All qualified applicants will receive consideration for employment without regard to age, sex, sexual orientation, gender identity, national origin, race, color, religion, disability or protected veteran status, or any other legally protected basis, in accordance with applicable laws.
For more information, visit MRHSclinics.com

Company DescriptionOur team of world class, award-winning physicians and specialists are driven to develop innovative 'body and mind' treatment plans for our patients, and to advance impactful medical research for all.

Apply Job!

For more such jobs please click here!