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Verification Specialist

Mount Vernon, IL

Post Date: 01/18/18 Job ID: 43713 Industry: Data Entry Clerk

HireLevel powered by Extra Help is seeking a Verification Specialist for our client located in Mt. Vernon, IL. The ideal candidate would have experience working with verification, documentation and medical records.

Job Type: Full Time

Pay Rate: $10/hour

Similar Positions: General Office, Clerical Support, Data Entry



Job Duties for the Documentation Specialist:
  • Verify eligibility and determine patient benefit coverage and product allowable.
  • Obtain and confirm the necessary dispensing order/ documentation on file.
  • Complete pre-certification/authorization. Obtain additional information such as medical necessity, letter of medical necessity or charts notes to submit for prior authorization.
  • Confirm Authorization/Orders are qualified prior to shipping. Release order for shipping once verification and necessary shipping requirements have been met.
  • Work with vendor billing and reimbursement services to resolve any verification issues as appropriate.
  • Keep updated on all benefit changes for third party insurance carriers within their area of responsibility.
  • Establish and maintain relationships with physician offices and other referral sources.
  • Maintain confidentiality of all information.

Job Requirements for the Documentation Specialist:
  • Must have at a high school diploma or equivalent
  • Experience with MS Office Suite and SAP.
  • Experience working with verification, documentation and/or medical records.
  • Experience using time management skills such as prioritizing/organizing and tracking details and meeting deadlines.
  • Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements.
  • Working knowledge of Medicare, Medicaid and Commercial payers, its rules and reimbursement.
  • Experience applying knowledge of medical terminology and verification.
  • Certified Coder or experience with medical coding specific to ICD-9/ ICD-10.
  • Must meet drug screening and background requirements

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