Position Title: Insurance Eligibility Coordinator

Position Summary:

We are seeking a highly organized and detail-oriented individual to join our team as an Insurance Eligibility Coordinator. In this role, you will be responsible for verifying insurance coverage and eligibility for patients, ensuring accurate billing and reimbursement processes. The ideal candidate will possess strong communication skills, the ability to navigate insurance systems efficiently, and a commitment to providing excellent customer service.

Key Responsibilities:

1. Verify insurance coverage and eligibility for patients prior to services rendered.
2. Collect and accurately record insurance information and benefits from patients and/or insurance providers.
3. Communicate with team, patients, insurance companies, and healthcare providers to resolve any insurance-related issues or discrepancies.
4. Coordinate with billing department to ensure accurate and timely submission of claims.
5. Stay informed about changes in insurance regulations, policies, and procedures.
6. Assist patients with understanding their insurance coverage, including co-pays, deductibles, and out-of-pocket expenses if needed.
7. Provide exceptional customer service by addressing patient inquiries and concerns related to insurance eligibility and coverage.
8. Maintain confidentiality of patient information in compliance with HIPAA regulations.
9. Collaborate with other healthcare professionals to optimize insurance processes and improve patient satisfaction.
10. Participate in training sessions and continuing education opportunities to enhance knowledge of insurance eligibility procedures and regulations.

Qualifications:

• Previous experience in healthcare administration, medical billing, or insurance verification is highly desirable.
• Strong understanding of insurance terminology, policies, and procedures.
• Excellent communication skills, both verbal and written.
• Proficiency in using computer systems and software, including electronic health records (EHR) and insurance verification platforms.
• Ability to multitask and prioritize tasks effectively in a fast-paced environment.
• Attention to detail and accuracy in data entry and record-keeping.
• Strong problem-solving skills and ability to work independently as well as part of a team.
• Knowledge of HIPAA regulations and patient confidentiality standards.

This job description outlines the primary duties and qualifications required for the Insurance Eligibility Coordinator position. The role may evolve over time based on organizational needs and industry changes.