Accounts Receivable Specialist at HighFive Dental Holdco LLC

Homewood, Alabama, United States -

Full Time

Start Date

Immediate

Expiry Date

08 Jun, 26

Salary

0.0

Posted On

10 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Verification, Eligibility Verification, Pre-authorization, Claim Denials, Patient Estimates, Insurance Carriers, Payer Portals, Practice Management System, HIPAA Compliance, Revenue Cycle Management, EHR Systems, Communication, Customer Service, Attention To Detail, Medical Terminology

Industry

Medical Practices

Description

Description The Healthcare Insurance Verification Specialist is responsible for ensuring that patients insurance information is accurate and up to date before services are provided. This role involves verifying insurance coverage, benefits, eligibility, patient estimates, and ensuring that pre-authorization requirements are met to prevent claim denials and delays. The specialist will collaborate closely with insurance companies, healthcare providers or patients to ensure seamless billing and reimbursement. The goal is to maintain and verify appointment schedules 5 days in advance. Duties and Responsibilities · Confirm and validate patient insurance coverage by contacting insurance carriers, using online eligibility systems, payers, portals or reviewing insurance documentation provided by the patient or provider. · Ensure that patient eligibility is verified for the correct dates of service and that the insurance covers the specific procedures or services to be provided. Confirm out-of-pocket costs, co-pays, co-insurance, and deductibles and estimates and create patient treatment plans. Ensure minimal denials due to eligibility-based denials ongoing. · Communicate directly with insurance companies to clarify any questions or discrepancies regarding a patient’s coverage, benefits, or pre-authorization status. · Inform patients of their insurance coverage, benefits, co-pays, deductibles, and financial responsibilities. Answer any patient inquiries about insurance verification and coverage. · Accurately enter insurance information, verification results, and patient financial responsibilities into the practice management system. Maintain accurate, up-to-date records. · Investigate and resolve any discrepancies or issues with patient insurance coverage, which may include denied or rejected claims, incorrect information, or issues with coverage dates. · Work closely with billing and coding teams to ensure that insurance verification information is integrated into the billing system and that claims are processed without delay. · Adhere to all healthcare regulations, including HIPAA, and ensure insurance verification processes comply with insurance industry standards and healthcare laws. · Track and report on the status of verification and estimate process. Follow up on any pending verifications to ensure timely completion. · Meet or exceed required accounts per day to meet HighFive and provider’s expectations. Requirements High school diploma or equivalent; associate or bachelor’s degree in healthcare, business, or a related field preferred. · Minimum of 2 years of experience in insurance verification, healthcare billing, or revenue cycle management. · Knowledge of healthcare insurance plans (e.g., Dental, PPO, HMO, etc.) and billing process preferred. · Proficiency in using Electronic Health Record (EHR) systems, online eligibility verification systems, and other healthcare billing software. · Prior experience with mid or large-scale healthcare business oUice of 100 or more providers preferred · Knowledge of medical terminology and healthcare insurance processes, including claims, benefits, and authorization procedures. · Strong attention to detail with the ability to accurately verify and document insurance information. · Excellent communication and customer service skills to interact with patients and insurance providers. · Ability to work independently and manage multiple tasks in a fast-paced environment. Preferred Skills: · Certification in healthcare insurance verification or revenue cycle management (e.g., Certified Insurance Verification Specialist).

Responsibilities

The specialist is responsible for verifying patient insurance information, eligibility, and benefits prior to services to ensure accurate coverage and meet pre-authorization requirements. This involves collaborating with insurance companies and providers to facilitate seamless billing and reimbursement while maintaining accurate appointment schedules.