Pbs Prereg And Ins Verification

Insurance Verification Specialist

At Legacy, everything we do is driven by a shared mission: making life better for others. How can you contribute to that mission? By being the go-to expert who verifies insurance and clarifies liability questions. Your keen attention to detail and accuracy will help strengthen the patient-physician relationship, ensuring patients have the insurance information they need for expert care.

If this sounds like you, we invite you to apply for this Insurance Verification Specialist role.

Responsibilities

Insurance Verification Specialist:

• Provides professional, accurate and timely insurance verification, initiates and secures authorization, notification of in-scope hospital services based on requirements for medical and other liability plans.
• Obtains plan benefit information and creates hospital cost estimates for expected patient liability in preparation of financial communication with patients.
• Specializes in payor type such as Commercial, Workers Compensation, Medicare, Medicaid, or Other Liability.
• Acts as a resource to patients, family members, physicians and other departments regarding medical and/or other liability policy benefits, authorization guidelines and plan limitations.

Qualifications

Education:

• Associate degree in business or healthcare, or equivalent experience, required.

Experience:

• Two years of directly applicable healthcare business office experience (billing/credit/collection) or applicable insurance customer service experience required.
• Demonstrated knowledge of insurance guidelines, including benefits and authorization protocols.
• Hospital insurance verification experience preferred.

Skills:

• Strong written and verbal communication and demonstrated effective interpersonal skills which promote cooperation and teamwork.
• Ability to problem solve in a timely, professional manner.
• Demonstrated knowledge of Payor/Plan structures, Medical policies, Payor contracts and Payor laws.
• Knowledge of CPT and Diagnosis coding and medical terminology.
• Net Typing of 40 wpm and PC based computer skills.
• 10 key proficiency.
• Knowledge of online eligibility systems and status review of claims.
• Works efficiently with minimal supervision, exercising independent judgment within stated guidelines.
• Ability to withstand varying job pressures, organize/prioritize related job tasks, and excellent attention to detail.
• Excellent public relations skills and demonstrated ability to communicate in calm, businesslike manner.
• Ability to multitask, learn new skills and adapt to change.
• Ability to work in a fast-paced environment independently or as part of a team.

Pay Range

USD $21.25 - USD $30.39 /Hr.

Our Commitment to Health and Equal Opportunity

Our Legacy is good for health for Our People, Our Patients, Our Communities, Our World. Above all, we will do the right thing.

If you are passionate about our mission and believe you can contribute to our team, we encourage you to apply—even if you don't meet every qualification listed. We are committed to fostering an inclusive environment where everyone can grow and succeed.

Legacy Health is an equal opportunity employer and prohibits unlawful discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion or creed, citizenship status, sex, sexual orientation, gender identity, pregnancy, age, national origin, disability status, genetic information, veteran status, or any other characteristic protected by law.