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Backend Insurance Verification Jobs in Ohio (NOW HIRING)

LTA Research

Senior Software Engineer (Ohio)

Akron, OH · On-site

$125K - $150K/yr

Develop comprehensive test sets for validation and verification of released software. * Lead root ... Basic front-end and back-end software architecture-based development. What We Offer! * Relocation ...

LTA Research

Senior Software Engineer (Ohio)

Akron, OH · On-site

$125K - $150K/yr

Develop comprehensive test sets for validation and verification of released software. * Lead root ... Basic front-end and back-end software architecture-based development. What We Offer! * Relocation ...

LTA Research

Senior Software Engineer (Ohio)

Akron, OH · On-site

$125K - $150K/yr

Develop comprehensive test sets for validation and verification of released software. * Lead root ... Basic front-end and back-end software architecture-based development. What We Offer! * Relocation ...

Loop

Senior Software Engineer

Columbus, OH · On-site

$155K - $195K/yr

Model what good verification looks like, not just for your own PRs, but in how you give feedback on ... Your Experience: * 5+ years building web applications, backend services, and APIs. Strong PHP ...

Loop

Senior Software Engineer

Columbus, OH · On-site +1

$155K - $195K/yr

Model what good verification looks like, not just for your own PRs, but in how you give feedback on ... Your Experience: * 5+ years building web applications, backend services, and APIs. Strong PHP ...

Loop

Senior Software Engineer

Columbus, OH · On-site +1

$155K - $195K/yr

Model what good verification looks like, not just for your own PRs, but in how you give feedback on ... Your Experience: * 5+ years building web applications, backend services, and APIs. Strong PHP ...

Matrix Research, Inc.

Digital Design Engineer

Dayton, OH · On-site

$129K/yr

By designing RF-front and back-end systems that can be integrated into various platforms, you will ... Proficiency in all aspects of FPGA design and verification, familiarity with FPGA timing and ...

All JobsBackend Insurance Verification JobsBackend Insurance Verification Jobs in Ohio

Backend Insurance Verification information

What is the difference between Backend Insurance Verification vs Front Desk Insurance Verification?

AspectBackend Insurance VerificationFront Desk Insurance Verification
Primary ResponsibilitiesProcessing insurance claims, verifying coverage electronically, and handling billing issuesChecking insurance information at patient check-in, collecting documents, and initial verification
Work EnvironmentOffice-based, often in billing or administrative departmentsFront desk, reception area, patient check-in stations
Required CredentialsKnowledge of insurance policies, billing software, and healthcare regulationsBasic insurance knowledge, customer service skills, and administrative training
Common UsageUsed in billing departments for detailed claim processingUsed at the point of patient intake for initial verification

Backend Insurance Verification involves processing insurance claims and verifying coverage electronically within billing departments, while Front Desk Insurance Verification focuses on initial patient insurance checks at the front desk. Both roles require insurance knowledge but differ in responsibilities and work environment.

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Backend Insurance Verification jobs near you
VERIFICATION SPECIALIST - North Therapy (Outpatient)

VERIFICATION SPECIALIST - North Therapy (Outpatient)

Aultman Health Foundation

North Canton, OH • On-site

$15.25 - $18.75/hr

Other

Posted 3 days ago

Job description

Legal Entity
Aultman Hospital
Position Summary
The primary responsibility of the verification specialist is to perform verification prior to outpatient Therapy visits to ensure accurate and reliable front-end patient demographic and insurance information, along with authorization requirements in order to produce clean claims and eliminate back-end denials.
Department Summary
Outpatient Therapy Services includes Occupational Therapy, Physical Therapy and Speech Therapy. Each clinic provides varying specialty services within the scope of these fields, such as LSVT, FCE's or Vestibular rehabilitation. Some clinic locations may also provide wellness services such as Tai Chi, exercise/balance classes, massage therapy or Reiki.
Qualifications
  • High school graduate or equivalent.
  • Clerical experience and Microsoft Office proficiency are preferred.
  • Experience in office setting or billing setting preferred.
  • Knowledge of basic medical terminology, anatomy, physiology and disease process.
  • Knowledge of insurance payers.
  • Obtain and maintain current American Heart Association (AHA) training in Basic Life Support (BLS) utilizing Resuscitation Quality Improvement (RQI) is required.
Department Qualifications
Skills
  • Excellent telephone and interpersonal communication skills are required.
  • Ability to communicate professionally to team members in multiple formats (verbal, handwritten, instant message and email).
  • Demonstrates the ability to utilize computer hardware, software programs, and/or the Internet (Ex. EMR, government & commercial on-line programs, access insurance carrier information, use excel or word, etc.).
  • Ability to clearly document key insurance information in medical record as directed.
  • Demonstrate understanding of general billing guidelines for therapy services in outpatient setting.
Responsibilities & Expectations
  • Demonstrates the ability to meet all critical responsibilities and expectations of the Registration/scheduler position. May be required to provide routine weekly coverage or in cases of urgent need, as identified by the Therapy leadership team.
  • Verification of all patient insurance information at least two days in advance of initial visit for prescheduled visits, or same day for add-on visits. This includes but is not limited to:
    • Checking active coverage eligibility and in-network status.
    • Copayment or Coinsurance Amount.
    • Policy coverage and limitations such as: CPT code restrictions, visit limits, personnel restrictions, per day unit charge maximums.
    • Visit authorization requirements
    • Verification that all information obtained is correctly entered into the appropriate electronic registration systems (e.g. Cerner) utilizing approved clearance systems for error resolution timely.
    • Follow up with patients directly if there are discrepancies, missing information or if insurance is ineligible, prior to their appointment. Restart verification process if new information obtained.
    • Timely cancellation of appointments in scheduling system due to insurance issues to ensure accuracy of daily schedules, along with notification to patient.
    • Document accurately in EMR in approved manner: verified insurance name along with non-covered services/restrictions and any authorization requirements or no authorization requirements for clinician/registration awareness.
  • Authorization tracking and submissions: Obtain a prior authorization if required by patient's insurance plan once evaluation has been completed and treatment plan has been established by the therapist. This includes but is not limited to:
    • Downloading/printing needed medical records (evaluation/cert letter, provider order, outcomes measure data) and submitting through specific insurance preferred routes (portal, fax, telephone review).
    • Clarifying necessary evaluation information or requested CPT codes/quantities, frequency of care with evaluating therapist or therapy leadership in therapist absence.
    • Maintaining tracking methods to ensure all new evaluations requiring auth have had auth submitted and approvals/denials received.
    • Communication of denials and options with therapist, patient and leadership PRN.
    • Submission and tracking of auth renewals in collaboration with therapist.
  • Assist with creation, modification and maintenance of reference materials for staff to aid in proper identification of insurances and related authorization requirements as requested.
  • Assist as directed with review of adjustments and denials.
  • Assist with training and mentoring of new registration and/or verification staff.
  • Any other duties relating to the business operation of the practice that may be assigned by the manager.
  • The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent to this position.
Working Conditions
  • Hours of operation with shifts as assigned including occasional overtime, on-call or off-shifts (evenings and/or weekends) scheduled as necessary to meet clinic needs.
  • Lunch and break periods must be coordinated with other staff members to maintain adequate staffing during hours of operation.
  • Subject to frequent interruptions and changes in priority of duties throughout the day.
  • Subject to emergency and other crisis situations.
  • Interactions with patients and visitors with physical and/or cognitive disabilities

Hazardous Exposure Category
Category II - Includes tasks that involve no exposure to blood, body fluids, or tissues, but employment may require performing unplanned Category I tasks. The normal work routine involves no exposure to blood, body fluids, or tissues by exposure or potential exposure may be required as a condition of employment. Appropriate protective measures will be readily available to every employee engaged in Category II tasks.
Physical Addendum
Demands
Frequency
Remarks
Lifting 0-10 lbs
Frequent 34-65%
Lifting 10-20 lbs
Occasional 10-33%
Lifting 20-35 lbs
Occasional 10-33%
Lifting 35-50 lbs
Never
Lifting 50-75 lbs
Never
Lifting 75-100 lbs
Never
Lifting over 100 lbs
Never
Forward Reaching
Frequent 34-65%
Overhead Reaching
Occasional 10-33%
Standing
Occasional 10-33%
Walking
Occasional 10-33%
Sitting
Continuous 66% of the day
Climbing
Never
Stairs/Ladder
Occasional 10-33%
no ladder
Bending/Stooping
Occasional 10-33%
Twisting/Turning
Occasional 10-33%
Kneeling/Squatting
Occasional 10-33%
Crawling
Never
Pushing/Pulling 0-10 lbs
Occasional 10-33%
Pushing/Pulling 10-20 lbs
Occasional 10-33%
Pushing/Pulling 20-35 lbs
Occasional 10-33%
Pushing/Pulling 35-50 lbs
Never
Pushing/Pulling 50-100 lbs
Never
Pushing/Pulling over 100 lbs
Never
Carrying 0-10 lbs
Occasional 10-33%
Carrying 10-20 lbs
Occasional 10-33%
Carrying 20-35 lbs
Occasional 10-33%
Carrying 35-50 lbs
Never
Carrying 50-100 lbs
Never
Carrying over 100 lbs
Never
Grasping/repetitive sustained
Continuous 66% of the day
Fine motor coordination
Continuous 66% of the day
Vision: Near/Far/Color
Continuous 66% of the day
Hearing: ordinary conversation/other
Continuous 66% of the day
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, disability, gender identity, sexual orientation or protected veteran status. The organization is an EEO/AA Employer M/F/Disability/Vet.
The organization will provide reasonable accommodations to employees or applicants with disabilities, as defined by the Americans with Disabilities Act, who are otherwise qualified to safely perform the essential functions of the job, with or without accommodation, unless such accommodation would constitute an undue hardship on the organization or poses a direct threat to the health and safety of the individual or others that cannot be sufficiently mitigated by reasonable accommodation. Any applicant or employee who requires an accommodation to perform the essential functions of his or her job or to enjoy equal benefits and privileges of employment should notify the Aultman Human Resource Department and request such an accommodation.

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