Reimbursement Insurance Verification Specialist

Job Summary:

Do you love working in non-profit? The Reimbursement Insurance Verification Specialist ensures that services are billed correctly and paid on time. This role involves verifying insurance coverage, handling claims, and following up on any denied or unpaid claims. The specialist works closely with the billing team, insurance companies, and patients to resolve issues and ensure accurate payments.

Key Responsibilities:

• Insurance Verification:
  • Confirm insurance coverage and benefits for mental health services.
  • Obtain pre-authorizations when needed.
  • Check for co-pays, deductibles, and coverage limits.
• Claims Follow-Up:
  • Submit and track insurance claims to ensure they are paid.
  • Follow up on denied or unpaid claims, fixing errors and resubmitting as needed.
  • File appeals for denied claims and provide additional information if required.
• Denial Management:
  • Identify common reasons for claim denials and work to reduce them.
  • Keep records of all follow-up actions and claim statuses.
• Patient Assistance:
  • Explain insurance benefits and out-of-pocket costs to patients.
  • Answer any billing and insurance questions.

Qualifications:

• High school diploma or equivalent.
• At least 2 years of experience in insurance verification, claims, or billing.
• Familiarity with mental health insurance and medical billing.
• Good communication and organizational skills.
• Experience with billing software and electronic medical records.