Medical Insurance Verification Specialist in Carlsbad, California at The Neurology Center

We are seeking an experienced Medical Insurance Verification Specialist to join our growing neurology practice. This is not an entry-level position. The ideal candidate must have a strong understanding of medical insurance plans, eligibility verification, authorizations, and managed care. Candidates without direct medical insurance verification experience will not be considered.

• Minimum of 2 years of medical insurance verification experience in a physician practice or specialty clinic.
• HMO and PPO insurance plans
• Medicare and Medicare Advantage
• Medi-Cal
• Commercial insurance plans
• IPA/Medical Groups
• Referral and authorization requirements
• Experience working with major California health plans and medical groups.
• Strong understanding of insurance eligibility and benefit verification.
• Excellent attention to detail and problem-solving skills.
• Ability to prioritize work in a fast-paced medical environment.
• Strong computer skills and experience using an EMR.
• Experience navigating Insurance Portals

Responsibilities:

• Verify patient insurance eligibility and benefits prior to appointments.
• Review referrals and authorization requirements.
• Understand and verify HMO, PPO, Medicare, Medicare Advantage, Medi-Cal, and commercial insurance plans.
• Identify contracted and non-contracted health plans and medical groups.
• Verify PCP assignments and medical group affiliations.
• Obtain and document insurance information accurately in the electronic medical record (EMR).
• Communicate with insurance companies, medical groups, referring offices, and patients regarding coverage and authorization requirements.
• Resolve insurance discrepancies prior to patient appointments.
• Work closely with scheduling, referrals, and clinical staff to ensure timely patient care.
• Maintain strict confidentiality

*Self-motivated with a strong work-ethic, solid interpersonal skills and excellent organization and prioritization skills.

*Excellent phone etiquette and customer service skills

*Work efficiently under deadlines *Dependable / Punctuality is a must.