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Chase Brexton Health Care · 1 day ago

Patient Coverage Verification Specialist

Baltimore, MD

Full-time

Onsite

Entry Level

$19/hr - $25/hr

1+ years exp

Chase Brexton Health Care is seeking a Patient Coverage Verification Specialist responsible for providing exceptional customer service to patients while verifying their insurance coverage for scheduled appointments. The role involves communicating effectively with patients and staff, ensuring accurate data entry, and assisting with preauthorization processes.

Health CareMental Health

Responsibilities

Verify eligibility, coverage, and benefits for all scheduled patients

Determines any copays/coinsurance/deductible amounts that are patient responsibility and makes a note in the appointment comment for the Patient Service Representative to collect

Stays 2 days ahead of verifying coverage for appointments. Since Medicaid coverage is month to month, ensures Medicaid is verified at the beginning of every month and works to get caught back up to the 2 day window of coverage verification

Arranges treatment authorizations from payers when needed for payment, and tracks authorizations and notifies providers when a new authorization is needed (if applicable to payer)

Detects and corrects errors, completes forms, obtains needed information and maintains logs and files

Strong interpersonal and telephone communication skills

Clearly and effectively interacts with staff of the care team or insurances to communicate information

Assures timely follow-up and communication

Reaches out to patients who have a sliding scale that is about to expire to or may have expired to inquire about coverage

Responsible for providing accurate and complete data input for preauthorization requests while providing exceptional customer service to CBHS staff, patients, caregivers, and family members that may be contacted

Tracks and follows up on all preauthorization requests to Insurances or Providers

Provides prompts, efficient and personalized assistance to meet the requirements, requests, and coverage needs of patients

Identifies patient coverage needs and issues and works to resolve the problems prior to the arrival of the patient for their appointment

Explains basic insurance terminology and procedures related to the patient obtaining care from the providers

Create and maintain a patient-centric atmosphere of warmth, personal interest and positive emphasis, as well as a calm environment

Handle telephone and written inquiries

Enter information into Patient Management System and EMR

Maintains patient confidentiality

Complies with federal and local patient privacy laws

Verifies patient and or/guardian identification

Document services by initiating appropriate forms, entering client data into the EMR, and ensuring all documentation is appropriately signed and dated

Carry out various quality assurance activities, such as collecting client feedback regarding problems with insurance reimbursement

Assists in coverage for other service lines

Performs other tasks as needed

Maintains open relationships and lines of communication with co-workers

Present ideas and suggestions when opportunities for improvement present of existing services based on interactions

Serves as a resource and subject matter expert for their defined area of work

Works closely with care team and providers to process any prior authorizations

Qualification

Coverage verificationCustomer serviceElectronic Medical RecordsMedical terminologyBilingualHIPAA knowledgeInterpersonal skillsTime managementOrganizational skillsProblem-solvingTeamwork

Required

High school, G.E.D. or equivalent

One year of customer service experience and coverage verification experience

Strong interpersonal and telephone communication skills

Clearly and effectively interacts with staff of the care team or insurances to communicate information

Assures timely follow-up and communication

Tracks and follows up on all preauthorization requests to Insurances or Providers

Provides prompts, efficient and personalized assistance to meet the requirements, requests, and coverage needs of patients

Identifies patient coverage needs and issues and works to resolve the problems prior to the arrival of the patient for their appointment

Explains basic insurance terminology and procedures related to the patient obtaining care from the providers

Create and maintain a patient-centric atmosphere of warmth, personal interest and positive emphasis, as well as a calm environment

Handle telephone and written inquiries

Enter information into Patient Management System and EMR

Maintains patient confidentiality

Complies with federal and local patient privacy laws

Verifies patient and or/guardian identification

Document services by initiating appropriate forms, entering client data into the EMR, and ensuring all documentation is appropriately signed and dated

Carry out various quality assurance activities, such as collecting client feedback regarding problems with insurance reimbursement

Assists in coverage for other service lines

Performs other tasks as needed

Maintains open relationships and lines of communication with co-workers

Present ideas and suggestions when opportunities for improvement present of existing services based on interactions

Serves as a resource and subject matter expert for their defined area of work

Works closely with care team and providers to process any prior authorizations

Verify eligibility, coverage, and benefits for all scheduled patients

Determines any copays/coinsurance/deductible amounts that are patient responsibility and makes a note in the appointment comment for the Patient Service Representative to collect

Stays 2 days ahead of verifying coverage for appointments

Arranges treatment authorizations from payers when needed for payment, and tracks authorizations and notifies providers when a new authorization is needed (if applicable to payer)

Detects and corrects errors, completes forms, obtains needed information and maintains logs and files

Maintains knowledge of insurance information as it relates to provider credentials

Confirm patient insurance coverage prior to initial appointment and document benefits for all new insurances in Practice Management System

Must possess excellent interpersonal skills

Basic understanding of HIPAA and PHI

Basic navigational knowledge of electronic medical record applications such as CPS12

Must have good time management skills, be organized, self-motivated

Possess excellent written and verbal communication skills

Maintain a high level of productivity and confidentiality

Work well in a team environment

Can enter data with ability to check accuracy of detail work such as correct spelling of names, numbers, dates and times

Ability to handle multiple tasks at once without mistakes or diminution of professional demeanor and customer service

Effectively able to prioritize and maintain workflow

Ability to function in a high volume, multiple task environments, possibly in a closely shared workspace

Demonstrate self motivation and the ability to work with a high degree of independence

Ability to effectively and efficiently solve problems as presented in real time

Strong organizational and task prioritization skills

Preferred

Knowledge of medical terminology preferred

Experience with Electronic Medical Records Systems

Bilingual

Company

Chase Brexton Health Care

When you think about health care what comes to mind? Medical exams? Health insurance? Shots? At Chase Brexton Health Care, we think about ‘care.’ When patients come to Chase Brexton for their health care, they receive more than medical attention.

Founded in 1978

Baltimore, Maryland, USA

501-1000 employees