Byram Healthcare Verifier in White Plains, NY at Byram Healthcare

Date Posted: 8/27/2018

Job Snapshot

Job Description

Essential Job Functions

Answers questions from customers, clerical staff, insurance companies, and physician offices
Makes outbound calls to obtain appropriate documentation for reimbursement of orders shipped
Work well in a team environment
Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion
Problem-solving skills to research and resolve discrepancies, and prior approval denials
Identify payer issues and independently create workflows or training processes to troubleshoot and support the management staff
verifies customer benefits via phone, fax, and web portal
Reviews and approves documentation received by third parties for submission to payers
Documents activities in ERP system in an accurate and timely manner
Provides feedback to Group Team Lead regarding issues with accounts
Conducts routine tasks as directed under clearly defined guidelines
Contributes to specific objectives and outcomes as directed
Consults with senior peers on non-complex projects
Performs additional duties as directed

Education & Experience Required:
Associate's Degree
One or more years of customer service experience
Or any combination of education and experience to meet the above requirements

Knowledge Skills & Abilities
Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems
Proficiency or familiarity with utilizing insurance web portals such as Navinet, Availity, Emedeon, and/or Epaces
Familiarity with medical terminology and insurances HCPC/ICD-9 codes, CPT and ICD-10 Coding
Knowledge of medical terminology likely to be encountered in medical claims
Basic skills with moderate level of proficiency
Effective communication abilities for phone contacts with insurance payers to resolve issues
Customer service skills for interacting with medical staff, patients and insurances regarding medical records and pending prior approvals
Ability to multitask
Working knowledge of Microsoft Office, particularly Word and Outlook

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