Kennedy Krieger Institute

INSURANCE VERIFICATION SPECIALIST

US-MD-Baltimore
Department
Care Management
ID
2916
Pos. Category
Administrative and Office Support - Other
2901 E. Biddle Street
# of Hours
40

Overview

JOB ID:  2916

 

the Insurance Verification Specialist will verify and interpret outpatient benefits to ensure maximum payment for the services rendered as determined by the referral source and KKI triage staff. In addition, the IVS will assist patients and their families to obtain any authorization, referral or pre-certification which may be required for payment of services.  The Insurance Verification Specialist performs all duties in a team environment demonstrating flexibility in work assignments and a commitment to the Department’s mission and goals.

 

Responsibilities

  1. Verify, interpret and accurately document patient health insurance or payment source.
  2. Estimate self-pay portions after benefits have been determined (deductibles, co-pays, non-covered services)
  3. Document clearances and follow up efforts.
  4. Maintain CMO guidelines regarding timelines for clearances, authorizations, etc.
  5. Maintain contact and correspondence with patients and families to keep them informed of pending insurance clearances and/or coverage and/or issues
  6. Maintain regular and timely contact with internal KKI customers (team leaders, Patient Accounting, Finance, and other department staff) regarding pending insurance clearances or coverage issues.
  7. Forward supporting documentation in a timely manner to Care Centers, patient accounting and clinical areas where applicable.
  8. Maintain browser and all IAMS Error Logs in a timely and accurate manner.

Qualifications

EDUCATION:

  • HS Diploma required.
  • AA degree preferred.

 

EXPERIENCE:

  • 1 year related experience with insurance benefit verification in a healthcare setting

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