Insurance Liaison

Insurance Liaison at Community Health Net

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Insurance Liaison

• Erie, PA
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• Finance Department
• $13.84 - $16.50 / hour
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• Insurance Liaison
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Summary

Under the direction of the Controller, the Insurance Liaison plays a crucial role in fostering communication and collaboration between the Federally Qualified Health Center (FQHC) and various insurance providers. This position is responsible for managing insurance-related processes, verifying patient coverage, and ensuring accurate billing and reimbursement.

Essential Duties and Responsibilities

• Insurance Verification:
• Verify patients' insurance coverage and eligibility.
• Collaborate with patients to obtain necessary insurance information.
• Update and maintain accurate insurance records.
• Billing and Coding:
• Work closely with billing and coding staff to ensure accurate claims submission.
• Review claims for completeness and accuracy before submission.
• Address any insurance-related issues emerging during the billing process.
• Communication with Insurance Providers:
• Establish and maintain strong relationships with insurance company representatives.
• Regularly communicate with insurance representatives accordingly.
• Stay informed about changes in insurance policies and procedures.
• Patient Education:
• Provide patients with information regarding their insurance coverage and benefits.
• Assist patients in understanding and navigating the insurance process.
• Address patient inquiries related to insurance matters.
• Claims Resolution:
• Investigate and resolve insurance-related claim denials and/or rejections by means of the worklog.
• Work proactively to prevent claim denials through accurate documentation and communication.
• Maintains all passwords for the Managed Care/Third Party carriers who allow verification via provider websites.
• Maintains confidentiality of all information/adheres to all HIPPA guidelines/regulations.
• Responsible for ensuring external and internal telephone calls are answered in a professional and timely manner in accordance with department policies, procedures, and performance goals.
• Perform other duties that may be assigned by Controller.

Requirements/Qualifications

• High school diploma or General Education Degree (GED)
• Preferred minimum of three (3) years' experience in one or more of the following: Medical/ Dental Coding Certification and/or knowledge of Current Medical Terminology (CMT), Current Dental Terminology (CDT)
• Relevant work experience in a medical or dental office setting.
• Higher level knowledge of Excel
• Ability to effectively communicate both verbally and in writing. Additionally, establish and maintain effective working relationships with employees, departments, and the public.
• Ability to work independently and with a team to obtain objectives.
• Proficient in office productivity tools such as Google, email, scanner, etc.
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