Insurance Verification and Billing Support Specialist

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Boulder Care

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Description

• The Insurance Verification & Billing Support Specialist is responsible for overseeing the front end billing process for patients, including eligibility verification and patient insurance updates. • This role will work closely with other teams to ensure quick resolution to eligibility issues, prior authorizations, and other patient billing inquiries. • Responsible for verifying insurance eligibility and benefits for all New Boulder commercial enrollments. • Conveying policy benefit and eligibility information to patients in a comprehensive and professional manner. • Assist with difficult Insurance Verification or other barriers to validating the insurance details for enrollment or changes to established patients. • Acts as first point of contact for incoming ZenDesk patient messages and the Slack channel #insurance-questions, pertaining to insurance and billing issues. • Will maintain ongoing dated eligibility checks for accurate billing and clean claims. • Responsible for insurance eligibility verification for the Prior-Auth team as needed. • Collaboration with other Boulder teams to assist with patients who have lapsed coverage and need temporary “Boulder Assist” assigned.

Requirements

• 5+ years of experience in a healthcare setting specific to billing, and accounts receivable • Ability to interpret and apply insurance payer billing guidelines, claim rules, and contract terms • Proficiency in government, commercial and/or insurance payer claims follow-up, denial resolution, and appeals processes • CPT and ICD coding knowledge • Knowledge of ANSI 837 and 835 files, including how to read and interpret • Exceptional written and verbal communication • Team-focused; effective collaboration. Serves both the team and the customer at a consistently high level • Demonstrates problem-solving and analytical skills appropriate for the position • Demonstrates high ethical standards of behavior • Maintains composure under pressure • Regularly demonstrates Boulder’s core values

Benefits

• Contribution to meaningful, life-saving work! • Comprehensive medical, dental, vision, and short-term disability benefits designed to take care of our employees and their families • Mental Health Services including MDLive, Talkspace, and EAP • 4 weeks of PTO accrued per calendar year with a tenured increase to 5 weeks at 2 years of employment • Sick leave accrued at 1 hr for every 30 hrs paid • 9 Paid Holidays per year • 12 weeks of 100% paid parental leave for the birth or adoption of a child (after 6 months of employment) • 401(k) retirement savings • Remote friendly with hardware provided to complete your work duties