Insurance Verification Coordinator II
Apply Now Job ID 1173549
Category Health Insurance Operations
Position Purpose: Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits Serve as the point of contact for key physicians’ offices and coordinate referrals with the sales team during insurance verification process
Serve as the point of contact or designated rep for contracted payors
Serve as the point of contact or designated rep for special pharma accounts working with their HUB’s and collecting and documenting pharma specific data in the system
Verify medical benefits for highly complex disease states, such as IVIG and infusion drugs
Obtain and verify insurance eligibility for services provided and document complete information in system
Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
Collect any clinical information such as lab values, diagnosis codes, etc.
Determine patient’s financial responsibilities as stated by insurance
Configure coordination of benefits information on every referral
Ensure assignment of benefits are obtained and on file for Medicare claims
Bill insurance companies for therapies provided
Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
Handle inbound calls from patients, physician offices, and/or insurance companies
Resolve claim rejections for eligibility, coverage, and other issues
Education/Experience: High school diploma or equivalent. 2+ years of medical billing or insurance verification experience. Working knowledge of payors and prior authorization requirements.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.