Insurance Specialist

JOB DESCRIPTION: Insurance Specialist

REPORTS TO: Insurance Supervisor

Why GLEC?

At Great Lakes Eye Care our core focus is to provide Christ-like, compassionate eye care. We 
provide exceptional multi-specialty treatment of eye disease for our communities and 
worldwide.

Our core values are:

• Selfless, Christ-like care for others.
• Relentless pursuit of excellence.
• Passion for patient experience.
• Teachable spirit, curious mind.

As an Insurance Specialist, you must be able to work in a fast-paced environment and multi-task. This person is responsible for billing surgeries, obtaining collections of payments over the phone and in person. Obtain prior authorizations, pre- authorizations, A/R, patient calls and posting of electronic payments. Lets delve into the key duties and qualifications:

Duties and Responsibilities:

• Ensure all insurance claims are filed promptly and that denied claims are researched correctly and re-submitted to insurance companies.
• Accurately post insurance payments, familiar with fee schedules to ensure payment amounts are correct.
• Post all charges in a timely manner to coincide with month-end reports.
• Support collection practices and policies.
• Maintain cordial and professional attitude when interacting with patients and coworkers. 
• Confirm name, current address, date of birth, and current insurance for all interactions with 
patients.
• Answer all telephone and written inquiries from insurance companies and patients.
• Assist coworkers in job duties when necessary.
• Participate in all cross-training efforts within the department.
• Bill surgeries, including adding operative reports into EMR. 
• Collect any prepay amounts prior to surgeries.
• Obtain prior authorizations for upcoming procedures.
• Verify insurance benefits using a variety of websites, or via telephone if necessary.
• Enter insurance referrals and authorizations.
• Work accounts receivable in a timely manner.
• Prepare outgoing mail, organize incoming mail.

REASONING ABILITY:

Ability to demonstrate customer-focused interpersonal skills in order to interact in an effective manner with physicians, staff, patients, and families. Ability to collaborate with all teams and various levels of personnel as part of a team. Ability to organize, prioritize, and have time management skills. Ability to work extended work hours beyond normal work schedule to include but not limited to evenings, extended shifts, and or extra shifts on short notice.

PHYSICAL DEMANDS:

Long periods in stationary positions required throughout work period. The person in this position needs to frequently move about inside the office. The person in this position frequently communicates with patients, patients families, co-workers, and doctors. Must have ability to cope with physical and mental stress. May require assisting wheel chair or physically challenged patients.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Potential exposure to fumes, dust gases, and odors. Frequent changes in temperature may occur. Possibility of exposure to communicable disease. Awareness of exposure as a high-risk environment.

Nothing in this job description restricts managements right to assign or reassign duties and 
responsibilities to this job at any time. This description reflects managements assignment of essentialfunctions; it does not proscribe or restrict the tasks that may be assigned. This job description is subject to change at any time