Insurance Verification Representative

Overview
Magna Health Systems is seeking a dedicated and knowledgeable Insurance Agent to join our team. The ideal candidate will possess a strong understanding of insurance processes, particularly in the medical field. This role is essential for ensuring accurate insurance verification and managing client interactions effectively. The Insurance Agent will play a crucial role in facilitating communication between clients and insurance providers while adhering to industry regulations. The Insurance Verifier is responsible for in-advance verification of patient benefits and coverage.

Duties

• Advises and consults with the team members and vendors concerning issues relating to insurance verification.
• Investigates coverage related issues and arranges for follow-up with accounts needing attention from other members of the team or management
• Enters payer and benefit information to facilitate billing and clean claim submission.
• Reviews and updates information related to benefits and coverage as necessary.
• Prepares reports for the team members and management as necessary.
• Acts as a resource personnel to patients, physician offices, facility staff, team members, and management.
• Audits and keeps track of the accounts due for insurance verification, authorizations, referrals, and the date of service collections.
• Communicates issues relating to insurance verification that may negatively impact reimbursement or clean claim submission.
• Obtains necessary documentation such as additional member information, letters of medical necessity, letters of protection, authorizations, referrals etc. when required to secure reimbursement.
• Verifies benefits in accordance to regulatory guidelines and internal policies and procedures.
• Contacts payers for clarification and confirms validity of coverage when necessary.
• Relates coverage, benefit, and up front amount due information to the patients in a timely fashion.
• Provides accurate estimates and discusses payment options for the day of surgery collections with the patients.
• Alerts patients, physician offices, facility staff, and management about any coverage changes or insurance policy issues that might negatively affect reimbursement or patient responsibility.
• Strives to provide accurate and timely verification for cases scheduled at least two weeks out.

Requirements

• Proven experience in insurance verification or related fields is preferred.
• Familiarity with medical coding practices and terminology is essential.
• Strong understanding of HIPAA regulations and patient confidentiality requirements.
• Excellent communication skills, both verbal and written, to interact effectively with clients and healthcare professionals.
• Ability to work independently as well as collaboratively within a team environment.
• Detail-oriented with strong organizational skills to manage multiple tasks efficiently.
• Prior experience in a medical office setting is a plus but not mandatory.

Qualifications

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• High school diploma or GED equivalent; or six months to one-year related experience and/or training; or equivalent combination of education and experience. Knowledge and experience in medical billing are desirable

Join us as we strive to provide exceptional service in the insurance industry while supporting our clients' needs effectively.

Job Type: Full-time

Pay: $17.00 - $24.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Vision insurance

Work Location: Remote