PrideStaff | Job Details

Job Details

« Back to Search Verification Specialist
Carlsbad, CA

Salary: $14.00
Date Posted: November 14, 2017
Job Type: Temporary to Hire
Job ID: 282590

Job Description

PrideStaff has an immediate VERIFICATION SPECIALIST position for a great organization in North County.

ESSENTIAL JOB FUNCTIONS

  • Answer calls from regional office locations, insurance companies and representatives of insurance companies using exemplary customer service skills.
  • Accurately enter and scan required information into computer database.
  • Follow standardized processes and work flow as required for job functions.
  • Review structured regional clinical data matching it against specified encounter(s) and follow established procedures for authorizing request and establishing benefits and eligibility for said encounter(s).
  • Enter obtained information with precertification numbers as needed.
  • Report data ran two-three times daily with emphasis on daily encounters scheduled, as well as new patient same day encounters.  Report data then worked in advance with next days’ schedule as priority.
  • Maintain patient confidentiality as defined by state, federal and company regulations.
  • Review errors and denials for regional assigned clinics.  Properly communicating these issues back to the Verification Supervisor.
  • Establish effective rapport with other employees, professional support service staff, customers, clients, patients, families and clinicians.
  • Have EHR Familiarity with note retrieval.
  • Actively support departmental and corporate strategic plans to ensure successful implementation.
  • Maintain cooperative working relationships with all clinic PSR staff and clinicians.
  • Research and correct invalid or incorrect patient demographic information such as invalid date of birth or insurance policy number to ensure proper billing and clean claims initiatives.
  • Responds professionally to all inquiries from patients, staff, and payors in a timely manner. 

Experience

  • High School Diploma or equivalent certification.
  • One year experience working in healthcare system preferred.
  • One Year eligibility, verification experience on an automated patient accounts system preferred.
  • Understanding of clinic operations, related to patient registration, referrals, authorization & cash collections.
  • Comprehensive working knowledge of third party insurance processes required.
  • Intermediate to expert knowledge and computer skills including Windows programs and database applications preferred.  Includes good keyboard skills 45+ wpm with high accuracy rate.