Insurance Specialist

• Verify and validate patient insurance coverage and eligibility before services are provided, ensuring there are no billing surprises later.
• Coordinate with healthcare providers to ensure accurate submission of claims in line with insurance requirements.
• Work with insurance companies to resolve discrepancies or denials related to patient coverage and claims.
• Educate patients about their insurance benefits, co-pays, deductibles, and any potential out-of-pocket costs.
• Maintain detailed records of insurance communications, including coverage verification and claim submission details.
• Assist patients and the healthcare team in resolving insurance-related issues and ensuring smooth processing.

Requirements and skills:

• In-depth knowledge of health insurance plans, billing procedures, and payer requirements.
• Strong understanding of insurance verification processes and claim submissions.
• Good problem-solving skills and attention to detail.
• Excellent communication and customer service skills, particularly in dealing with patients and insurers.
• Proficiency in insurance management systems and medical billing software.
• Prior experience in insurance verification or claims management is preferred.