Jr Insurance Verification Agent

hace 1 semana

San Francisco, Heredia, Costa Rica Auxis A tiempo completo

Job Summary:

The Jr Insurance Verification Agent will be working to ensure that reinstatements, modifications, and cancellations of insurance policies are timely and accurately updated in the necessary databases. You will have an important role in determining the patient's insurance status and the extent of insurance benefits, ensuring an efficient billing process for medical providers.

Responsibilities:

Duties will be performed by each individual depending on the assignment of responsibilities:

  • Reviews patient accounts for accuracy before placement to outside collection vendors

  • Receive account change requests and review required changes.

  • Update insurance plan changes to customer accounts.

  • Review account information and update required information, balances, etc.
  • Researches and responds to vendor inquiries
  • Reviews correspondence in the CWF system and takes appropriate action and documents action
  • Reviews and authorizes affidavits related to patient billing, as applicable.
  • Ensures vendor inventories reconcile to SSC systems by completing recons and updating I-Plans and or placements as needed by the end of each month.
  • Assist with the Medicaid Eligibility vendor reconciliation, as requested. Manages the onboarding and termination process for vendors
  • Provides support during vendor transitions: Medicaid Eligibility, Early Out, Primary, and Secondary agencies.
  • Handles, eRequest, and correspondence from collection agencies.
  • Willingness to be shadowed on site by new hires, if designated.
  • Responds to requests which include research payments, contractual, approving arrangements, audits, etc.
  • Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"

Skills and Experience:

  • English – Spanish Language (Oral and writing B2+ or above).
  • Must have a high school diploma.
  • At least 6 months of experience in Data Entry or Customer Service positions.
  • The resource will adjust its local schedule with the resources supporting this position during Daylight Saving Time changes in the Eastern Time Zone.
  • A genuine interest in working with and helping customers.
  • Demonstrated experience in providing high levels of customer satisfaction and performance in a high transaction volume/high demand environment is required.
  • Good presentation and a polite, tactful, and friendly character.
  • Healthcare experience is a plus

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