Insurance Verification Specialist-Onsite

Iloilo, Iloilo

Posted more than 30 days ago

Company:: TMDPH INC
Company Description:: Total Primary Care (TPC), the USA-based parent company and trade name of TMDPH Inc., was founded in 2014 in Austin, Texas by brothers Robert and Andrew Sek, driven by their vision to use a technology platform to grow and scale a healthcare group that provides exceptional primary care services to patients. TPC’s early years were marked by experimentation and learning, initially offering a wide spectrum of ancillary services before refining its focus on primary care. Since its inception, TPC has experienced substantial growth, expanding its operations into new markets, including launching the Dallas-Fort Worth area in 2018, San Antonio in 2021, Houston in 2022 and launching its first specialty division Total Behavioral Health in 2022. The PH subsidiary, TMDPH, Inc. was launched in 2021 to support TPC’s US operations and growth plans. At the core of Total Primary Care's success is its unwavering commitment to high-quality primary care, exemplified by significant investments in condition management programs. These programs have evolved over time to ensure that patients receive the best care and support. The company's dedication to offering top-tier primary care has become synonymous with the Total Primary Care brand. Total Primary Care's culture is guided by core values (T.E.A.R) Teamwork, Excellence, Accountability, and Respect. It places a strong emphasis on technology and patient-centered care, setting it apart in the healthcare industry. As the company marks over a decade of dedicated service, its vision for the future is clear - to continue delivering the best possible healthcare to its patients, with a particular focus on expanding its value-based care initiatives. As Total Primary Care continuously grows, its relentless commitment to healthcare excellence remains at the heart of its journey. The company's future is poised for further growth and innovation, built upon a foundation of high-quality primary care and an unwavering commitment to its patients' well-being. Our Vision We will improve the overall health of society by focusing on the underserved male patient population and the Medicare (aged 65+) population. Our Mission We will be the dominant primary care provider in Texas (to start) by offering a full suite of primary care and complementary specialties (e.g. behavioral health) and ancillary services to create a ‘one-stop shop’ for men’s and Medicare member’s health care needs. Our Values Teamwork: We collaborate to solve problems to lead to better results. Excellence: We balance striving for perfection & making progress, always seeking better ways. Accountability: We take ownership from start to finish! Respect: We respect and encourage our employees & patients with high integrity, always. Our Clinical Brands Total Care Primary Care (Senior and Family Focus) Total Men’s Primary Care (Men’s Focus) Total Behavioral Health (Behavioral Health Focus) Our Team-PH Office Support TPC is powered by a team from the Philippines, each contributing their expertise to ensure TPC can provide seamless healthcare services to patients. The team includes Medical Scribes, Insurance Verification Specialists, Medical Coders, Kustomers, Billers, Referrals, Medical Records personnel, Order Fulfillment Specialists, and Behavioral Health Coordinators, all working together to provide comprehensive and high-quality support and solutions. The PH team is an amazing group of dynamic and agile team members located in the very heart of Iloilo City. Started with a handful of hardworking and dedicated freelance team members working from home way back in 2018; the team, who were graduates of Allied Medical courses, initially supported Medical Coding, Insurance Verifications and Referrals. From then on, more and more departments were created to support the growth of TPC and the US operations. With its office nestled within the center of Mandurriao, Iloilo City, one of the 4 main districts of the city; it is strategically located for all its team members as well as potential new hires given its proximity to top universities and colleges. With TPC positioned to continue its growth and expand its current services in the US, the Iloilo office is poised to grow further, always willing to be there to support back-office works of the clinics.
Contract Type:: Full Time
Experience Required:: 1 year
Education Level:: Bachelor’s Degree
Number of vacancies:: 2

Job Description

Position Overview:
We are seeking a meticulous and detail-oriented Insurance Verification Specialist to join our healthcare team at TMDPH Inc. The Insurance Verification Specialist plays a critical role in verifying patients' insurance coverage, ensuring accurate billing, and facilitating smooth administrative processes. If you have a strong understanding of insurance verification procedures, excellent communication skills, and a commitment to accuracy, we encourage you to apply for this position.

Key Responsibilities:
Verify patients' insurance coverage and benefits by contacting insurance providers, utilizing online portals, and reviewing insurance documentation.
Accurately record insurance information, policy details, and coverage limitations in electronic health record (EHR) systems.
Confirm patients' eligibility for medical services, procedures, and treatments based on insurance guidelines.
Collaborate with healthcare providers, billing teams, and administrative staff to ensure accurate billing and reimbursement.
Educate patients on their insurance coverage, co-pays, deductibles, and any pre-authorization requirements.
Obtain necessary pre-authorizations for medical procedures and treatments as required by insurance plans.
Assist in resolving insurance-related inquiries and discrepancies, coordinating with insurance companies to address issues.
Maintain patient confidentiality and adhere to ethical standards when handling sensitive insurance information.
Contribute to streamlining insurance verification processes and improving efficiency.
Ensure compliance with privacy laws, and data security guidelines, including Health Insurance Portability and Accountability Act (HIPAA) standards.

Qualifications:
Bachelor’s Degree in any field. Some college education in healthcare administration or related fields is preferred.
Familiarity with using insurance verification software, electronic health record (EHR) systems, and office applications.
Strong understanding of medical billing procedures, insurance plans, and coverage guidelines.
Excellent written and verbal communication skills for effective interactions with patients, insurance representatives, and medical professionals.
Exceptional attention to detail and accuracy in recording insurance information.
Experience:
Minimum of 1 year(s )experience in medical office administration, insurance verification, or a related role.
Undergraduate applicants with a minimum of 1 year experience is also considered for this position
Familiarity with various insurance plans, including Medicare, Medicaid, and private insurers.

Personal Attributes:
Professional and courteous demeanor when interacting with patients and insurance representatives.
Strong organizational skills to manage insurance verification processes efficiently.
Ability to work independently and collaborate within a healthcare team.
Adaptability to evolving insurance regulations and healthcare technologies.
If you are a dedicated Insurance Verification Specialist with a focus on accuracy and efficient insurance processes, we encourage you to apply by submitting your resume along with a cover letter outlining your relevant experience and interest in the position.