Easterseals Florida is seeking an experienced Insurance Verification Specialist to work in our Orlando office. The Insurance Verification Specialist verifies insurance and initiates the pre certification process of the children and families we serve. The ideal candidate will have a strong background in working with commercial insurance companies and Florida Medicaid managed care plans, have extensive knowledge of different types of coverage and policies with the skills necessary to verify patient insurance, and obtain prior authorization and other required documents for procedures. The successful applicant must be very detailed-oriented, organized, with the ability to focus and work quickly. Working well in a team environment is very important.
- Maintains tracking of client's on schedule, ensuring that eligibility and authorization information has been processed and stored in internal electronic filing systems
- Coordinates and performs verification of insurance benefits by contacting insurance provider by phone or online portals and determining eligibility of coverage and communicates status of verification/authorization process with appropriate team members in a timely and efficient manner
- Obtain authorization, and precertification for evaluation and/or therapy services that are part of the client's treatment plan
- Maintains updated referrals and authorizations for clients that are part of caseloads for therapist that are internal staff
- Provides clinical information as needed, emphasizing medical justification for procedure/service to insurance companies for completion of pre-certification process
- Acts as liaison between the referring physician's office, intake team, service coordinators, therapist, and insurance companies by answering questions, offering assistance, and relaying messages pertaining to authorization of procedure/service.
- Monitors insurance authorization issues to identify trends and participates in process improvement initiatives
- Responds to all inquiries from throughout the system and outside related to authorization/pre-certification issues
- Two years of experience in insurance verification, pre-certification, billing, or related insurance position; or equivalent combination of education and experience.
- Working knowledge of medical terminology preferred
- Detailed oral and written communications skills required
- Candidates should have solid typing speed and accuracy, and good computer skills, with the ability to utilize multiple computer systems in desktop environment to accomplish results
- Effective communication skills and the ability to work independently