Medical Insurance Specialist/Verification of Benefits and Prior Auth Coordinator

Kenosha Radiology Center - Kenosha, WI

Full-time - Entry Level

Kenosha, WI

Ambulatory Health Care Services

About the position

The Medical Insurance Specialist/Verification of Benefits and Prior Auth Coordinator is responsible for initiating and completing prior authorizations and benefit verifications for all radiology exams. This role requires a solid understanding of insurance benefit coverage and involves reviewing benefit-specific coverage with patients, setting up payment plans, and serving as a resource for front desk and scheduling staff regarding insurance inquiries. The position emphasizes patient care and outstanding customer service, ensuring a positive experience for patients and referring providers.

Responsibilities

• Conduct thorough insurance verifications for patients prior to their appointments.
• Initiate and complete prior authorizations for all radiology exams as required by insurance.
• Review and interpret insurance policies, coverage details, and benefits.
• Communicate effectively with insurance companies to obtain necessary information.
• Document verification results in the patient management system accurately and promptly.
• Collaborate with medical coding staff to ensure proper coding of services rendered.
• Maintain compliance with HIPAA regulations regarding patient information.
• Stay updated on changes in managed care plans and coding practices.

Requirements

• Strong understanding of insurance verification processes and medical terminology.
• Familiarity with medical coding systems, including ICD-10 coding.
• Knowledge of HIPAA regulations and managed care principles.
• Excellent organizational skills with attention to detail.
• Ability to work independently as well as part of a team.
• Strong communication skills, both verbal and written.
• Proficient in using office software and patient management systems.
• High School Graduate or GED.
• Ability to read and write in English, with good verbal and written communication skills.

Nice-to-haves

• Conversant in Spanish a plus.

Benefits

• 401(k)
• Dental insurance
• Employee discount
• Health insurance
• Life insurance
• Paid time off
• Vision insurance