Insurance Verification / Authorization Specialist

InfuSystem
US - Michigan - Rochester
January 8, 2025

The Insurance Verification/Authorization Specialist is responsible for verifying patient eligibility and obtaining authorization approvals for third party insurance payers with a focus on Veterans Affairs (VA) Community Care program. The idea candidate will have the ability to interpret benefit information, understand insurance terminology, and coordinate with insurance payers, VA Community Care providers and VA facilities to secure necessary documentation and approvals timely. The scheduled working shift for this position is Monday through Friday in a hybrid setting, working in the office a minimum of 3 days and 2 days from home. In office days will be Tuesday, Wednesday, Thursday.

IN THIS ROLE, THE IDEAL CANDIDATE WILL:

Review and confirm patient insurance details to ensure eligibility for services.
Initiate, follow up, and secure authorizations using fax, email, or telephone, including retrospective authorizations and renewals as needed.
Monitor and follow up on all pending authorizations within management designated timeframes to expedite the claims process.
Work closely with customer service and sales representatives to obtain supporting documentation, ensuring accurate processing and system entry.
Provide education to interested parties on correct procedures.
Accurately input payer plan IDs and other relevant data into appropriate systems to ensure accurate billing for current and future services.
Organize tasks efficiently to prevent revenue loss and ensure all documentation is processed correctly.
Other related tasks as assigned to support the department's objectives.

SUPERVISORY RESPONSIBILITIES:

There are no supervisory responsibilities

THE IDEAL CANDIDATE WILL HAVE THE FOLLOWING QUALIFICATIONS:

Associate degree (A. A.) or equivalent; two to four years related experience and/or training; or equivalent combination of education and experience.
Minimum of two years' experience in a healthcare setting
Proficiency in interpreting insurance benefits and terminology
Strong organizational skills
Highly motivated and detail-oriented
Strong problem-solving skills and ability to navigate complex processes
Effective interpersonal and communication skills
Ability to work as a team
Ability to independently meet tight deadlines in a project-based atmosphere
Follows department processes and procedures

PERSONAL AND PROFESSIONAL ATTRIBUTES:

The ideal candidate must be a rigorous analytical thinker and problem solver with the following professional attributes:

Strong work ethic
Sound judgment
Proven written and verbal communication skills
Natural curiosity to pursue issues and increase expertise
Pursue and design innovative analytical performance metrics
The courage to promote and defend ideas and analyses
Passionate about InfuSystem and serving customers and patients
Strives to make an impact on improving our business processes and results
Exemplary honesty and integrity
Ability to collaborate effectively and work selflessly as part of a team

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

COMPREHENSIVE BENEFIT PACKAGE:

At InfuSystem, we give our employees the tools to succeed both on and off the job. Our generous benefits package provides comprehensive coverage to help you protect your health and earning power and prepare for the future. In addition, we offer perks and programs that help you grow in your career and make InfuSystem a great place to work!

Health plan options that include an employer contribution
Health Savings Account (HSA)
Healthcare and Dependent Care Flexible Spending Accounts (FSA)
Dental and Vision premiums covered by InfuSystem
Life Insurance, STD & LTD
Paid Parental Leave
Adoption and Fertility Assistance
401(k) with a specified Company Match
Employee Stock Purchase Program
Tuition Assistance
Generous Paid Time Off plan
Employee Assistance Program
Competitive Pay
Employee Referral Bonus

Read the full job description and apply online on the recuiter's web-site

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