Insurance Verification Specialist

Position:

Insurance Verification Specialist

Winter Haven, FL

Insurance Verification Specialist (IVS)

Director of Revenue Cycle Management

Non-Exempt Personnel

None

Under general supervision the IVS is responsible for verifying insurance benefits, obtaining pre‑authorization and authorizations for all services rendered by the provider assigned to the team member. Works closely with center leaders, center staff and insurance companies to verify the patient’s individual benefits. Relies on extensive experience of the authorization process, understanding of insurance and ability to work independently in order to meet the goals of the department.

• High school graduate or equivalent required
• 3-4 years’ healthcare insurance verification experience required
• Knowledge of medical terminology or concepts is required
• Proficiency in Microsoft Office applications including Word, Power Point, Excel, and Outlook is required

• Responsible for the insurance benefits and authorization process.
• Submit Authorization to Insurance companies to include the use of “Cover my Meds” & “Availity” software among others.
• Submit additional paperwork, documentation necessary to authorize a medication or service.
• Responsible for correctly identifying and updating various types of insurance entry information.
• Understanding of the different product websites to get discounted pharmaceuticals for a patient’s benefit.
• Correctly document patient charts and complete the Authorization forms to assist coders in processing claims.
• Work closely with the HCA and other team members in order to make the registration and benefits process seamless.
• Ability to speak with different insurance companies via phone to identify correct coverage, benefit details and authorization needs.
• Proper phone etiquette when speaking with providers, staff and patients.
• Strong organizational, time management and documentation skills.

• Federal laws and regulations affecting coding requirements
• Electronic Health Records
• Knowledge of billing practices and billing office functions including FQHC environment
• Knowledge of medical records, EHR
• Must have good math skills and effective communication skills
• Must have good problem‑solving skills

• Communicating clearly and concisely, orally and in writing
• Confidentiality
• Ability to use the computer
• Ability to work independently to accomplish assigned work in a timely manner
• Ability to communicate with staff and the public, both in person and over the phone, in a tactful manner and under difficult situations
• Understanding and carrying out verbal and written directions
• Follow CFHC policies and procedures

• Federal Student Loan Forgiveness: PSLF – 10‑year commitment, 120 loan payments and at the end of the commitment, the remaining loan is forgiven
• Excellent medical, dental, vision, and pharmacy benefits
• Employer‑Paid Long‑Term Disability Insurance
• Employer‑Paid Life Insurance equivalent to 1x your annual salary
• Voluntary Short‑Term Disability, additional Life and Dependent Life Insurance are available
• Malpractice Insurance
• Paid Time Off (PTO) – Employees receive 20 days of PTO + 9.5 Holidays totaling 37.5 days of freedom per year when accounting for adjacent weekends!
• Paid Birthday Holiday
• CME Reimbursement
• 401(k) Retirement Plan after 1 year of service (with matching contributions)
• Staff productivity is recognized and rewarded

• Works under pressure and stress due to the diversity of our clinics
• Work is performed indoors in a heated, air‑conditioned, well‑lit and clean office setting
• Requires ability to distinguish letters, numbers and symbols
• Requires normal range of vision
• Requires awareness of personal limitations and flexibility
• Some emotional stress resulting from diversity and intensity of patients and staff
• Requires prolonged standing or sitting

External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case‑by‑case basis.