Insurance Specialist

March 10

⚔️ Virginia – Remote

Although this job is listed in Virginia, this company may be open to hiring remote in other states.

⛰️ West Virginia – Remote

Although this job is listed in West Virginia, this company may be open to hiring remote in other states.

⏱ Part Time

🟡 Mid-level

🟠 Senior

🔒 Insurance

Apply Now

Receive Emails with Similar Jobs

WVU Medicine

WebsiteLinkedInAll Job Openings

WVU Medicine is a comprehensive health system affiliated with West Virginia University, providing medical services through a network of hospitals across West Virginia. The system includes notable facilities such as J. W. Ruby Memorial Hospital, WVU Medicine Children's, and various other regional medical centers. WVU Medicine offers a wide range of healthcare services, including specialized and advanced medical treatments such as robotic heart surgery. It's also involved in medical education, research, and community health initiatives, emphasizing a mission of delivering high-quality care to the communities it serves.

neurosurgery • pediatrics • emergency medicine • cardiothoracic surgery • cancer services

10,000+ employees

⚕️ Healthcare Insurance

📋 Description

• Responsible for assuring all appointments and procedures are authorized. • Insurance carriers are contacted to verify coverage and benefit limitations. • Tests and procedures are pre-authorized and scheduled. • Deductibles, co-payments, account balances, and fees are calculated. • Responsible for minimizing reimbursement errors resulting from inaccuracy of referral and enrollment information. • Identifies all patients requiring pre-certification or pre-authorization at the time services are requested. • Follows up on accounts as indicated by system flags. • Contacts insurance companies or employers to determine eligibility and benefits for requested services. • Follows up with patients, insurance companies, or providers if there are insurance coverage issues. • Uses work queues within the EPIC system for scheduling, transition of care, and billing edits. • Performs medical necessity screening as required by third party payors. • Documents referrals/authorization/certification numbers in the EPIC system. • Initiates charge anticipation calculations. • Communicates with patients the anticipated self-pay portion co-payments/deductibles/co-insurance. • Assists Patient Financial Services with denial management issues. • Communicates problems hindering workflow to management in a timely manner. • Assesses all self-pay patients for potential public assistance.

🎯 Requirements

• High school diploma or equivalent. • State criminal background check and Federal (if applicable), as required for regulated areas. • Previous insurance authorization experience.