Department
Reimbursement

Position
Insurance Verifier

Position Summary

Responsible for verification of new insurance benefits for existing diabetic patients.

Essential Duties and Responsibilities

• Makes outbound calls to Medicare, Medicaid and private insurance companies to obtain benefit information
• Evaluates patient insurance coverage to determine compatibility with CCS Medical’s program
• Determines if selected products are appropriate based on patient need and insurance benefit plan
• Updates and re-files claims when necessary
• Communicates directly with patients regarding their insurance benefits and coordination with CCS Medical products and programs

Other Responsibilities

• Assists other office personnel in the performance of their duties as assigned and as workload permits
• Participates in on-going training for compliance, product information, and insurance benefits to augment knowledge of procedures, regulations, and products
• Follows all Medicare, Medicaid and Private Insurance regulations and requirements
• Actively participates in Continuous Quality Improvement programs
• Demonstrates thoroughness with all work related activities; strives to continually improve quality and productivity results displayed by department personnel on an ongoing basis
• Maintains and promotes patient confidentiality
• Maintains open lines of communication with Administration, department management and other departmental personnel
• Assumes other duties and responsibilities as assigned by the department supervisor
• Maintains scheduling flexibility to ensure availability to meet the needs of the department for all hours of operation
• Abides by all policies, procedures and protocols set forth in the departmental, CCS Medical Personnel and Administrative Policy Manuals

Position Accountability

Quality Control: Ensures accurate information relating to benefits, products, and procedures is properly conveyed to patients; ensures that company philosophies, policies, and procedures regarding patients, government agencies, and other vendors are maintained
Customer Service: Ensures that patient relations are treated with the highest level of customer service, per company policies
Records: Ability to add, delete and update patient records
Compliance: Ensures effective documentation and adherence to Medicare and Private insurance guidelines
Records: Responsible for maintaining accurate patient records
Confidentiality: Adheres to HIPAA guidelines, company privacy and confidentiality policies

Responsibility

Reports to: Department Supervisor/Manager
Supervisory: None

Primary Customers

Internal: Departmental employees, managers, supervisors, and team leads referencing insurance and Medicare information
External: Patients and insurance companies regarding specific information relating to benefit plan changes and coordination with CCS Medical’s program

Knowledge Skills and Abilities Required

• High school diploma or GED equivalent, and one to two years experience with medical insurance verification or authorization, or equivalent combination of education and experience
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals; ability to write routine reports and correspondence; ability to speak effectively before groups of customers or employees of the organization
• Ability to add, subtract, multiply and divide all units of measure, using whole numbers, common fractions and decimals
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists; ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form

Physical Requirements

• Frequent: Speaking; hearing; sitting; use of hands/fingers; handling or feeling objects, tools or controls; close vision; color vision; peripheral vision; ability to adjust focus
• Occasional: Standing; walking indoors; reaching with hands and arms; stooping; kneeling; crouching; crawling; lifting and/or move up to 10 lbs

Desired Key Competencies

• Proficient with various Microsoft Office software such as Word, Excel and PowerPoint
• Strong communication skills
• Good interpersonal relation skills
• Strong multi-tasking skills
• Planning, organization, and execution skills
• Facilitation/presentation skills
• Time management
• Information management
• Flexibility to adapt to changing environment and different learning styles

Work Environment

Moderate noise level similar to typical office environment with computers, printers and light traffic.

To apply for this position, please email or mail a cover letter and your resume to:

CCS Medical
Attn: Recruitment Department
14255 49th Street North
Suite 301
Clearwater, FL 33762

Fax: 727-507-2879
Voice: 727-507-2227
E-mail: recruiter@ccsmed.com