Insurance Verification Specialist I

With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics nationwide. Through its Products & Services segment, Hanger distributes branded and private label O&P devices, products and components, and provides rehabilitative solutions to the broader market. With 160 years of clinical excellence and innovation, Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value. Collectively, Hanger employees touch thousands of lives each day, helping people achieve new levels of mobility and freedom.

We are seeking an Insurance Verification Specialist I - Remote. This role will review patient information to ensure insurance coverage is active and contact health insurance companies to verify eligibility and benefits from within an organization that provides healthcare patient services. Work with third-party payers to obtain pre-certification prior to scheduled procedures and services. Document and maintain accurate registration and benefits information for patients complete and communicate current status of authorizations, claims, and appeals. Work hours: 8:00 - 5:00 pm (PST)

Principal Duties and Responsibilities (Essential Functions):

Promote the values of Hanger
• Reviews documentation to ensure meets needs of payer and medical policy
• Verifies diagnosis code on patient billing is accurate and reimbursable
• Communicates with clinic staff to obtain necessary documentation
• Communicates with insurance companies to verify patient benefits
• Determine insurance financial information such as coinsurance, deductible, etc. used to determine patient responsibility
• Coordinate with clinic if items are determined to be not covered
• Submit authorization request to insurance companies and follows up as needed
• Ensures authorizations provided by insurance companies are accurate and contain correct codes, quantities and appropriate authorization date ranges.
• Updates patient chart with necessary notations, authorization numbers, and documentation
• Contact third-party payer to validate patient's coverage
• Contact patient for updated insurance information
• Perform other duties as assigned

Required:

• High school diploma or equivalent
• Less than 1 year of related experience

• Minimum good fit for the job, as determined by the Talent Bullseye assessment. Hanger will administer the Talent Bullseye as part of the selection process.

Preferred:

• Medical terminology knowledge
• Pre-Authorization knowledge/experience
• Knowledge of insurance payer requirements
• Experience with EMR systems (NextGen and/or OnBase)
• Basic computer knowledge
• DME/Orthotic knowledge

• Able to initiate communication with clinic staff and insurance companies
• Excellent customer service and communication skills
• Able to manage multiple responsibilities and to prioritize duties/tasks in a fast paced working environment
• Good interpersonal, oral and written communication skills, including the ability to follow written and verbal directions
• Resourceful and flexible team player who excels at building trusting relationships with patients, referral sources and colleagues
• Working knowledge of HIPAA and other medical insurance regulations and terminology for private payer, state and federal plans including coding, billing and reimbursement protocols
• Working knowledge of ICD-9, ICD-10, HCPC/CPT and other coding
• Proficient computer software; such as MS Word, Excel, and automated billing systems
• Able to use various type of office equipment; such as, facsimile machines, calculator, postage machine, copiers, etc.
• Knowledge of state, federal and regional collection and reimbursement laws
• Must have an enthusiastic and positive attitude
• Ability to work independently, exercise creativity, and be attentive to detail
• Proficiency with basic math and accounting skills
• Act with integrity in all ways and at all times, remaining honest, transparent, and respectful in all relationships.
• Keep the patient at the center of everything that you do, building lifelong trust.
• Foster open collaboration and constructive dialogue with everyone around you.
• Continuously innovate new solutions, influencing and responding to change.
• Focus on superior outcomes, and calibrate work processes for outstanding results

Pay range of $18dph to $23.27dph + 5% annual bonus potential. This pay range is posted to comply with wage transparency laws. Hanger salary ranges vary based on skill, ability, knowledge, geographic location and other variables.

Employees working at least 20 hours per week are eligible for the following benefits:

• Competitive Pay
• Health Insurance
• Dental Insurance
• Vision Insurance
• 8 Paid Holidays per Year
• Paid Vacation Time Off
• Paid Sick Time Off
• 8 hours of paid time to volunteer in your community
• Floating Holiday
• Life Insurance
• Medical Flex Spend Account
• Dependent Care Flex Spend Account
• Free employee assistance program
• 401(k)
• Full-time employees are also eligible for short-term and long-term disability insurance

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