Insurance Verification Specialist
US-OR-PORTLAND

Job ID: 25-44440
Type: Regular Full-Time
Northwest 31st Bldg

Overview

At Legacy, everything we do is driven by a shared mission: making life better for others. How can you contribute to that mission? By being the go-to expert who verifies insurance and clarifies liability questions. Your keen attention to detail and accuracy will help strengthen the patient-physician relationship, ensuring patients have the insurance information they need for expert care.

If this sounds like you, we invite you to apply for this Insurance Verification Specialist role.

Responsibilities

• Provides professional, accurate and timely insurance verification, initiates and secures authorization, notification of in-scope hospital services based on requirements for medical and other liability plans.
• Obtains plan benefit information and creates hospital cost estimates for expected patient liability in preparation of financial communication with patients.
• Specializes in payor type such as Commercial, Workers Compensation, Medicare, Medicaid, or Other Liability.
• Acts as a resource to patients, family members, physicians and other departments regarding medical and/or other liability policy benefits, authorization guidelines and plan limitations.

Qualifications

Education:

• Associate degree in business or healthcare, or equivalent experience, required.

Experience:

• Two years of directly applicable healthcare business office experience (billing/credit/collection) or applicable insurance customer service experience required.
• Demonstrated knowledge of insurance guidelines, including benefits and authorization protocols.
• Hospital insurance verification experience preferred.

Skills:

• Strong written and verbal communication and demonstrated effective interpersonal skills which promote cooperation and teamwork.
• Ability to problem solve in a timely, professional manner.
• Demonstrated knowledge of Payor/Plan structures, Medical policies, Payor contracts and Payor laws.
• Knowledge of CPT and Diagnosis coding and medical terminology.
• Net Typing of 40 wpm and PC based computer skills.
• 10 key proficiency.
• Knowledge of online eligibility systems and status review of claims.
• Works efficiently with minimal supervision, exercising independent judgment within stated guidelines.
• Ability to withstand varying job pressures, organize/prioritize related job tasks, and excellent attention to detail.
• Excellent public relations skills and demonstrated ability to communicate in calm, businesslike manner.
• Ability to multitask, learn new skills and adapt to change.
• Ability to work in a fast-paced environment independently or as part of a team.