The Intake Representative is responsible for verifying insurance coverage and benefits with precision in a high-volume environment and performing monthly reverifications for current patients. This role requires extensive knowledge of insurance verification, identifying and troubleshooting claim rejections, and resolving issues related to insurance benefits. The position requires attention to detail, the ability to multitask, and a strong sense of urgency.
Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned.
- Conduct New Insurance Verification: Review and verify patients’ insurance information to ensure accurate billing and coverage.
- Monthly Insurance Reverification: Reverify insurance coverage and benefits for existing patients monthly to maintain up-to-date records.
- Identify and Resolve Claim Rejections: Research and analyze claim rejections, pinpointing causes related to insurance benefits and coverage issues.
- Communicate with Insurance Providers: Contact insurance companies to confirm patient eligibility, coverage details, and authorization requirements.
- Maintain Patient Records: Accurately document and update patient insurance information and verification notes in the system.
- Collaborate with Billing and Collections Teams: Work closely with billing and collections departments to address insurance-related rejections and optimize the claims process.
- Provide Exceptional Client Service: Communicate with facilities and other departments regarding insurance coverage and verification outcomes with professionalism and clarity.
- Monitor Policy Changes: Stay informed of changes in departmental policies, insurance policies, coverage criteria, and industry regulations to ensure compliance and accuracy.
- Verification Reports: Work and submit reports on verification activities, rejections, and resolutions for management review.
- Adhere to Confidentiality Standards: Handle all patient information in compliance with HIPAA and other privacy regulations, ensuring data security and confidentiality.