Required Skills
- Strong knowledge of patient scheduling, registration/intake processes, medical necessity reviews, insurance eligibility verification, authorizations, and billing practices.
- Accurately performs insurance verification with complete documentation of benefits, patient information, and financial responsibility in line with insurance contracts.
- Ensures precise data entry in all systems (verification tools, registration modules, comments, etc.) to maintain clean claims and error-free processing.
- Confirms that scheduled procedures are covered by payers when performed in an ASC setting.
- Proficient in using available calculators (Medicare, Workers’ Compensation, Out-of-Network, etc.) and calculating allowable amounts as directed by management.
- Demonstrates effective critical thinking, problem-solving, and decision-making abilities.
- Able to manage heavy workloads, competing requests, and tight deadlines with professionalism and efficiency.
- Quickly adapts to new processes, integrates changes into daily tasks, and takes ownership of responsibilities.
- Flexible, tactful, patient, and composed in handling complex or stressful situations.
- Willingness to perform additional duties as assigned.
Required Experience
- 2–5 years of experience in verification, authorization, or scheduling; Ambulatory Surgery Center (ASC) experience strongly preferred.
- Skilled in accessing benefits through multiple sources (phone, in person, online portals).
- Ability to interpret and explain patient benefits, including calculating allowable amounts and patient responsibilities.
- Strong judgment and interpersonal skills with proven abilities in critical thinking, problem-solving, and analysis.
- Excellent verbal and written communication with both internal teams and external clients.
- Proven ability to multitask, prioritize effectively, and meet deadlines in a fast-paced environment.
- Able to work independently and collaboratively within a team.
- Experience with various healthcare insurance payers is preferred.
- Proficiency in Microsoft Office Suite (Excel, Outlook, Word).
- Familiarity with Advantx, gMed, HST, and Waystar systems preferred.
- High School Diploma or equivalent required.