Top 68 Insurance verification specialist Jobs in Germantown Md

Payor Clearance Specialist
Children's National Hospital —Silver Spring, MD
- $48,672 - $81,120 a year
- Full-time
- Bilingual
- Mid-level
- 3 years
Referral and Authorization Specialist - Practice Support
Frederick Health —Frederick, MD
- $17.51 - $22.66 an hour
- Overtime
- Microsoft Outlook
- HIPAA
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Client Care Specialist
FYZICAL Therapy and Balance Centers —Rockville, MD
- Full-time
- Hybrid work
- High school diploma or GED
- Clinic
- Driver's License
- Opportunities for advancement
Quick Apply
Customer Service Representative
FYZICAL Therapy and Balance Centers —Rockville, MD
- Full-time
- High school diploma or GED
- Clinic
- Driver's License
Quick Apply
Human Resources Specialist (Employee Benefits)
US Administrative Office of the U.S. Courts —Washington, DC
- $77,771 - $136,348 a year
- Online Application
- Pass drug screening
- Mid-level
- Office
- Life insurance
Pre-Registration Specialist, Per Diem
Samaritan —Washington, DC
- $21.10 - $26.26 an hour
- Part-time
- Remote
- Mid-level
- High school diploma or GED
- Mentoring
Quick Apply
Intake & Scheduling Specialist Home Healthcare
Human Touch Health Care —Washington, DC
- $21 - $25 an hour
- 8 hour shift
- Microsoft Excel
- Mid-level
- Office
- Health insurance
- Dental insurance
Quick Apply
3d
Benefits Specialist
HARKINS BUILDERS INC —Columbia, MD
- $70,000 - $80,000 a year
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Profit sharing
- Paid jury duty
Cardiovascular Scheduler, Day Shift, Cardiology
Adventist HealthCare —Silver Spring, MD
- $20.07 - $26.42 an hour
- Full-time
- Bilingual
- Hospital
- Customer service
- Free parking
- AD&D insurance
7d
Authorization & Verification Specialist - Acute Team
ContinuumRx —Chantilly, VA
- Full-time
- Microsoft Word
- Microsoft Excel
- HIPAA
Quick Apply
Mission Support Specialist
US Immigration and Customs Enforcement —Washington, DC
- $46,610 - $91,815 a year
- Online Application
- Hybrid work
- Background check
- Psychiatry
- Pass drug screening
- Paid holidays
- Loan repayment program
7d
Revenue Cycle Specialist
United Theranostics —Chevy Chase, MD
- $26 - $32 an hour
- Full-time
- Hybrid work
- Mid-level
- 3 years
- Bachelor's degree
- Paid holidays
- Disability insurance
Quick Apply
11d
Benefits & Auth for Physical Therapy
RSI-Rehabilitation Services, Inc. —Laurel, MD
- $23 - $29 an hour
- Full-time
- Medical office experience
- HIPAA
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Patient Service Representative/Procedure Scheduler
DIGESTIVE CARE SPECIALISTS LLC —Germantown, MD
- $20 - $24 an hour
- Full-time
- Spanish
- Mid-level
- Perioperative Care
Quick Apply
6d
Client Care Specialist
Fyzical —Rockville, MD
- High school diploma or GED
- Clinic
- Driver's License
- Opportunities for advancement
Insurance Authorization Specialist
VSI —Reston, VA
- From $23 an hour
- Full-time
- Mid-level
- Office
- Bachelor's degree
- Paid time off
- 401(k) matching
Quick Apply
Medical Staff Coordinator, Day Shift, Medical Staff
Adventist HealthCare —Silver Spring, MD
- $22.64 - $30.63 an hour
- Full-time
- Microsoft Word
- Microsoft Outlook
- Hospital
- Free parking
- AD&D insurance
PDN Home Health Authorization Specialist
COMFORT HOME HEALTH LLC —Falls Church, VA
- $25 - $30 an hour
- Full-time
- Hybrid work
- Spanish
- HIPAA
- English
- Health insurance
- 401(k)
Quick Apply
Medical Billing Specialist (Onsite)
Frederick Foot and Ankle Specialists, P.C. —Frederick, MD
- Full-time
- Mid-level
- High school diploma or GED
- Analysis skills
Quick Apply
Customer Service Representative
Fyzical —Rockville, MD
- High school diploma or GED
- Clinic
- Driver's License

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Payor Clearance Specialist

Children's National Hospital -
Silver Spring, MD

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Job Details

Full-time
$48,672 - $81,120 a year

Qualifications

Appeals
Overseeing health insurance pre-certification
Phone communication
Coding for hospital billing
High school diploma or GED
Healthcare referral management
Case appeal in utilization management
Medical billing and coding communication with insurance companies
Patient interaction
Health insurance referral requirements
Typing
Clinical confidentiality policies
Patient registration
Clinical documentation standards
Medical billing regulations compliance
Insurance claims appeal handling
Client interaction via phone calls

Full Job Description

Kids Are Our Everything.

Department

10119 Eligibility and Financial Clearance

Pay Range

$48,672.00 - $81,120.00

Payor Clearance Specialists are members of the Patient Access team dedicated to completing patient access workflows related to navigating insurance payor regulations. Facilitate increasing our patient's access into the care continuum. Decrease payor related barriers and increase financial outcomes for scheduled patient services for the inpatient, ambulatory , and physician practice settings. Payor Clearance Specialists work directly with referring physician offices, payers, and patients to ensure full payor clearance prior to the provision of care. Including, serving e as subject matter experts as it relates to payor requirements, authorizations, appeals and patient navigation. Works as a Payor Clearance Specialists use quality auditing and reporting tools to identify denial issues and trends to improve service line outcomes.

Minimum Education
High School Diploma or GED (Required)

Minimum Work Experience
3 years Healthcare experience with payor navigation, claims and billing, healthcare registration, insurance referral and authorization processes insurance authorizations, and appeals. (Required)
2 years Experience related to CPT and ICD coding assignment. (Required)

Required Skills/Knowledge
Ability to communicate with physicians’ offices, patients and insurance carriers in a professional and courteous manner.
Superior customer service skills and professional etiquette.
Strong verbal, interpersonal, and telephone skills.
Experience in healthcare setting and computer knowledge necessary.
Attention to detail and ability to multi-task in complex situations.
Demonstrated ability to solve problems independently or as part of a team.
Knowledge of and compliance with confidentiality guidelines and CNMC policies and procedures.
Knowledge of insurance requirements and guidelines for Governmental and non-Governmental carriers.
Previous experience with Cerner, Passport, or other related software programs and EMRs preferred.
Bilingual abilities preferred.
Successful completion all Patient Access training assessments required and meets minimum typing requirements.

Functional Accountabilities
Pre-Service Payor Clearance

Navigate and address any payor COB issue prior to service being rendered to ensure proper claims payments; obtain and ensure all authorizations are on file prior to services being rendered; work collaboratively with all departments/services of the Children’s National Medical Center to ensure all scheduled patients have undergone payor clearance prior to service; pre-register patients, verify insurance eligibility and benefits, obtain pre-certification or referral status, and collect patient responsibility amounts for services provided throughout the health system meeting departmental standards for productivity and quality .

Provide supporting clinical information to insurance payors, outcomes must decrease the need to peer-to-peer review.

Work with the Payor Nurse Navigators to decrease delays in patients access to care.

Follow established department policies to completely and accurately

Establish contact with patients via inbound and outbound calls and access department work queues to pre-register patients for future dates of service.

Verify insurance eligibility and benefits by utilizing integrated real-time eligibility tool, payer websites, and telephone calls to payers; document payer verification responses in designated fields within the registration pathway; validate insurance referral status, if applicable, and communicate with PCP office to obtain referrals.

Patient Navigation and Notification

Interpret insurance verification information to estimate patient financial responsibility amounts for scheduled services and inpatient stays.

Act as a liaison to ensure all of the appropriate custodial issues are resolved prior to the patients arrival.

Work as a patient advocate along with legal and other entities to remove any barriers prior to service.

Review and determine insurance plan benefit information and scheduled services and inpatient stays, include co-insurance and

deductibles. Compare and communicate in and out of network benefits accordingly.

Communicate patient financial responsibility amounts and initiate the point of service (POS) collections process; determine patient liability based on services level and make necessary recommendations.

Identify patients requiring payment assistance options and facilitate communication between patients and CNMC Financial Information Center (FIC).

Revenue Cycle Outcomes

Review clinical documentation to ensure clinicals provided supports desired outcomes prior to submitting to payor; must document proven outcomes of decrease peer-to-peer trends.

Measure decrease in rescheduled events due to lack of supporting clinical documentation.

Provide education to providers regarding payor requirements and clinical documentation.

Based on cases worked and outcomes, review claim denials for authorizations to identify trends, root causes, corrective actions and appeal options, provide monthly reports to support outcomes.

Obtain authorizations for add-on cases and procedures to ensure proper and timely claims payment; follow-up on all cases to ensure procedures authorized were performed, update authorizations as needed.

Become subject matter experts on payor requirements; write appeal letters to payers to obtain payment for services; Collaborate with individual departments - Compliance Department, Patient Financial Services, Case Management, and Centers of Excellence to reduce first pass denials.

The disclosed salary range includes the minimum and maximum rates within which Children’s National believes an individual’s base pay rate will fall for this position. It is not typical for an individual to be hired at or near the maximum of the pay range. The exact pay rate for this position will be based on a variety of factors in alignment with the Children’s National compensation philosophy. These factors are legitimate and non-discriminatory including, but not limited to, the current market conditions; organizational needs; the individual’s combination of prior work experience, level of education, knowledge, skills, and other qualifications. Children’s National is committed to providing a fair and competitive total rewards package to each of our employees. This base salary range does not include our comprehensive benefits package or any additional compensation for which this position may be eligible.

Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law. The “Know Your Rights” poster is available here: and the pay transparency policy is available here: Know Your RightsPay Transparency Nondiscrimination Poster.

Please note that it is the policy of Children's National Hospital to ensure a “drug-free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children's National and its affiliates maintain the right, in accordance with our policy, to enforce a drug-free workplace, including prohibiting recreational or prescribed marijuana.

Apply Now

Refine Your Search

insurance verification specialist jobs in germantown md

Payor Clearance Specialist

Referral and Authorization Specialist - Practice Support

Client Care Specialist

Customer Service Representative

Human Resources Specialist (Employee Benefits)

Pre-Registration Specialist, Per Diem

Intake & Scheduling Specialist Home Healthcare

Benefits Specialist

Cardiovascular Scheduler, Day Shift, Cardiology

Authorization & Verification Specialist - Acute Team

Mission Support Specialist

Revenue Cycle Specialist

Benefits & Auth for Physical Therapy

Patient Service Representative/Procedure Scheduler

Client Care Specialist

Insurance Authorization Specialist

Medical Staff Coordinator, Day Shift, Medical Staff

PDN Home Health Authorization Specialist

Medical Billing Specialist (Onsite)

Customer Service Representative

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