Insurance Claims Specialist

At VEBT, employees are our No. 1 investment. We are looking for a high functioning, detail-oriented professional who can juggle various tasks with accuracy and is interested in molding their career with an award-winning, growing company.

Duties and Responsibilities

- Researches and reviews all insurance plans and confirms patient benefit eligibility, including patient liabilities, clauses, and riders.

- Reviews and interprets insurance group pre-certification requirements. Ensures proper pre-authorizations have been obtained. Executes on-line operations for specific payors to complete the pre-certification process.

- Resolves discrepancies with the patient and/or family members, employers and insurance companies to assist in obtaining insurance information. 

- Interviews patients and/or family members; advises patient with regards to next steps or processes for securing financial coverage. 

- Reviews and analyzes third party COB screen prior to billing to prevent claims rejection. Works with patient or family member regarding outstanding COB issues.

- Maintains status of all accounts pending verification reviews, utilizing applicable work queues, and takes appropriate action to resolve accounts.

Qualifications

High school diploma or GED equivalent is required.
3 to 5 years experience related to healthcare insurance eligibility, insurance verification or insurance billing in a hospital/medical office setting.

This is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.