The INSURANCE VERIFICATION SPECIALIST performs clerical functions for patient billing, including verification of insurance information and resolution of problems to ensure a clean billing process . Follows up on accounts that require further evaluation. Works with others in a team environment.
What is the insurance verification process?
The health insurance verification process is a series of steps that checks whether or not the patient admitted has the ability to make a reimbursable claim to their health insurance provider . The process is complicated and goes through many different people at both the healthcare provider and the insurance provider.
How much does an insurance verification specialist make an hour?
| Annual Salary Hourly Wage | Top Earners $39,500 $19 | 75th Percentile $35,000 $17 | Average $33,152 $16 | 25th Percentile $29,000 $14 |
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How do I become a insurance verification specialist?
How to Become an Insurance Verification Specialist. Some insurance verification specialist jobs require an associate’s degree in medical administration or a related health field , while others may only need a high school diploma and on the job training.
How do I become an insurance specialist?
Becoming an insurance specialist will usually require education beyond a high school diploma or GED. Healthcare organizations prefer hiring insurance specialists with an associate degree from an accredited community college or vocational school .
Why are claims denied?
A rejected medical claim usually contains one or more errors that were found before the claim was ever processed or accepted by the payer . A rejected claim is typically the result of a coding error, a mismatched procedure and ICD code(s), or a termed patient policy.
How do I know if I qualify for insurance?
This can often be accomplished by checking the website of the insurance carrier or calling a representative of the insurance carrier. Some practice management systems and clearinghouses are also capable of checking patient eligibility.
Why is it important to verify a patient insurance?
Verifying coverage in advance allows the practice to estimate the total patient responsibility for payment . When patients are informed of their estimated total prior to appointments, they’re far more likely to come to the appointment prepared to pay or make payment plans.
How much does an insurance verifier make?
The salaries of Insurance Verifiers in the US range from $22,610 to $58,511 , with a median salary of $39,540 . The middle 57% of Insurance Verifiers makes between $39,540 and $45,725, with the top 86% making $58,511.
What does insurance specialist mean?
An insurance specialist interprets or explains insurance plans . This job is available in health care, government, and other sectors. ... An insurance specialist may also assess accident or insurance claims. Other specialists manage customer accounts and maintain contact with clients after the application process.
What is HIA certification?
The American Health Insurance Plans (AHIP) offers the Health Insurance Associate (HIA) certification. This certification is offered to insurance professionals who have passed the AHIP’s course of study. AHIP requires you to complete six online courses, each followed by a multiple-choice exam on the course content.
What are the duties of a billing specialist?
- Send invoices and account updates to clients.
- Keep an accurate record of client accounts and outstanding balances.
- Receive, sort, and track incoming payments.
- Validate debit accounts to ensure the credibility of payments.
- Issue receipts for received payments.
How much does AHIP certification cost?
Typically, the AHIP certification test costs $175 , but many carriers offer a discounted rate of $125 if you take the exam through their agent portals.
What are some professional opportunities available in the health insurance profession?
- Medical Insurance Claims Specialist.
- Medical Insurance Billing Specialists.
- Insurance Underwriters.
- Medical Coding Specialists.
- Health Informatics Data Analysts.
What are 5 reasons a claim may be denied?
- Your claim was filed too late. ...
- Lack of proper authorization. ...
- The insurance company lost the claim and it expired. ...
- Lack of medical necessity. ...
- Coverage exclusion or exhaustion. ...
- A pre-existing condition. ...
- Incorrect coding. ...
- Lack of progress.
What are 5 reasons why a claim may be denied or rejected?
- #1: You Waited Too Long. One of the most common reasons a claim gets denied is because it gets filed too late. ...
- #2: Bad Coding. Bad coding is a big issue across the board. ...
- #3: Patient Information. ...
- #4: Authorization. ...
- #5: Referrals.
