Insurance Verification Representative - Midwest Orthopaedic Consultants

Excellent opportunity for an Insurance Pre-Certification Coordinator to join an innovative, growth-oriented Orthopaedic practice who has earned a reputation for excellence and is highly respected by their colleagues, patients and the community.Under general supervision of the Insurance Lead, the Insurance Pre-certification Coordinator researches and obtains patient benefit information, regarding patients' insurance coverage, in order to ensure appropriate reimbursement and help in facilitating patients' treatment. ESSENTIAL DUTIES AND RESPONSIBILITIES:Responsible for the timely verification of medical insurance benefits for the service scheduled or service being provided via website and/or calling the payer (Managed Care payors, Governmental/State payors, Commercial payers, Workers Compensation, Motor vehicle accident cases)Contacts insurance companies to verify primary and secondary insurance coverage for both in-network and/or out of network benefitsWorks with the various departments to ensure necessary referrals, pre-certification and/or authorizations for scheduled services are obtained and on file are obtained and on fileReviews and resolves preauthorization/precertification/referral issues that are not valid and contacts insurance companies to verify/validate requirements to ensure accuracy and avoid potential billing denialsCarefully researches patient benefits with health exchanges and communicates with patient, Asst. Manager of Patient Accts, billing staff and medical providers prior to scheduled appointmentsAssists billing dept. with reimbursement appeals for denied claimsStrong emphasis will be placed on customer service and service excellenceMust be able to obtain information to respond to difficult patient and insurance inquiriesMaintain current knowledge and understanding of government rules and regulationsAnswers patient questions, inquires and concerns regarding their benefitsOther duties may be assigned. COMPETENCIES:Knowledge of ICD-10, CPT, HCPCS and Medical terminology. Excellent interpersonal, communication and customer service skills are required. Strong analytical and problem solving skills. Excellent verbal and written communication skills are a must. Ability to define problems collects data, establish facts, and draw valid conclusions. Maintain HIPAA confidentiality. EDUCATION AND EXPERIENCE REQUIRED: High school diploma or GED required and one year college or technical school highly desired.A minimum of 2-3 years' experience in healthcare insurance billing, verification, collections and/or authorization is required.Working Conditions/Physical Demands: Must be able to sit and work at a computer for extended periods Requires manual and finger dexterity and vision corrected to normal range. Travels between both locations Oak Lawn and Orland ParkMidwest Orthopaedic Consultants is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, Veteran status, disability or national origin.