Reports to the Director and works under the direction of the Manager. Reviews patient records using medical coding procedures. Verifies insurance eligibility and ensures the patients' healthcare benefits cover the required procedures. Assists in educating patients regarding insurance.
MISSION, VALUES and SERVICE GOALS
MISSION: We deliver outstanding care, inspire health, and connect with heart.
VALUES: Trust. Respect. Integrity. Compassion.
SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.
JOB SPECIFICATIONS
Education and Experience
A health insurance specialists must have extensive knowledge of the latest alphanumeric codes used in medical billing, so post-secondary training is required. The knowledge, skills, and abilities as indicated above are normally acquired through the successful completion of an associate's degree majoring in medical billing, medical coding, health informatics, health information technology or a related healthcare field certification. A minimum of 1 to 2 years of Medical Oncology work experience and/or insurance prior authorization and verification of benefits is required. Must have computer experience and be able to keep accurate insurance records.
Knowledge & Skills
The knowledge of medical terminology in regards to procedure and diagnosis codes, policies, legislation, equipment and professional disciplines.
Demonstrated communications and interpersonal skills necessary to effectively interact with patients and guarantors.
Knowledgeable in Medicare and Medicaid guidelines.
Must be tactful in handling patient problems often of a highly personal and confidential nature.
Must be able to maintain professionalism during frustrating interpersonal situations.
Analytical skills are a must for health insurance specialists to check for any billing errors and make the necessary modifications.
Detail-oriented with good organizational skills will help health insurance specialists file all essential insurance paperwork correctly.
Health insurance specialists need the technical skills to work with electronic health records, coding software, email, and databases.
Working Conditions
Ability to adapt to change and close working conditions.
Assigned hours within your shift, starting time, or days of work are subject to change based on departmental and/or organizational needs.
May need to travel to other Beacon locations.
Ability to adjust communication skills to the level of the patient and ordering providers.
Physical Demands
Prolonged periods of sitting and/or standing in front of a computer monitor.
Requires the physical ability and stamina to perform the essential functions of the position.
