Insurance Verification/Authorization Specialist

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about 2 years old

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EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum. For more information, visit www.eyecare-partners.com.

Insurance Verification Representative 

Summary

Our growing eye care organization has an immediate need for an Insurance Verification Representative who will handle all aspects of insurance verification for ophthalmology services and procedures.

Responsibilities

  • Obtain information about patient insurance coverage, benefits and eligibility that includes the following:  identifying out of pocket amounts (i.e., copay, deductible, co-insurance), determining the correct coordination of benefits, identifying if a replacement or supplemental plan exists, identifying termed coverage, and identifying if the patient’s plan is considered out of network coverage.
  • Run system-generated reports to verify insurance verification is being done timely prior to the patient’s date of service.
  • Document patient’s insurance benefits in applicable practice management system and estimated out of pocket amount.
  • Coordinate with authorization team to ensure patient has valid and active coverage as well as coordinate with front desk personnel and scheduling if patient benefits have termed.
  • procedures by insurances requiring authorization are being captured
  • Maintain productivity standards set by management and communicate issues in a timely and proactive manner.
  • As needed, assist Authorization team with obtaining insurance authorizations, including retro-authorizations.
  • Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements.

Requirements: Education, Experience & Skills 
 

  • High school diploma or equivalent required
  • 2+ years' experience medical authorizations  
  • Comprehensive understanding of insurance verification, contract benefits and medical terminology
  • Ability to enter data into various electronic systems while maintaining the integrity and accuracy of the data
  • Excellent verbal, written, and social skills

 

 Physical Requirements:

While performing the duties of this job, the employee is regularly required to talk and hear. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must frequently lift and/or move up to 10 pounds.

 Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

 If you need assistance with this application, please contact (636) 227-2600

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

 Please do not contact the office directly – only resumes submitted through this website will be considered.