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Insurance Verification Rep – Pediatric Psychology & Developmental Medicine – Medical College of Wisconsin – Brookfield, WI

Purpose

Under general supervision, perform routine and some advanced administrative duties requiring general knowledge of insurance verification policies and procedures.


Primary Functions

  • Contact insurance companies and utilize online tools to verify insurance benefits for outpatient and inpatient visits at the Child Development Center.
  • Complete and process prior authorizations as directed. Monitor number of patient visits per authorization. Complete pre-certifications.
  • Perform data entry of billing information into Epic.
  • Answer and resolve telephone inquiries regarding billing and insurance issues.
  • Assist callers with inquiries requesting estimates for services.
  • Advise providers regarding insurance changes and be familiar with CPT, DSM-5 and ICD-10 coding.
  • Coordinate self-pay arrangements for patient families.
  • Monitor monthly patient activity reports.
  • Receive and verify new patient referrals from PCPs. Contact provider or parents to assist with CDC referral process.
  • Provide assistance as needed to the Patient Scheduling Reps.
  • Perform other duties as assigned.

Preferred Schedule:

Full-time role with expectations for coverage during core business hours and flexibility required as necessary to accommodate business needs.

Position Requirements:

Specifications


Appropriate education and/or experience may be substituted on equivalent basis

Minimum Required Education: High school diploma

Minimum Required Experience: 1 year

Preferred Experience: Previous experience with medical billing and coding

Knowledge – Skills – Abilities

Knowledge of quality control, customer service standards, information management, procedural process, and recordkeeping. Knowledge of medical billing and coding including CPT, DSM-5 and ICD-10. Computer, technical, interpersonal, oral communication, listening, and patience skills.

Source: Indeed.com
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