• Insurance Verification Analyst

    Job Locations US-VA-Glen Allen
    Job ID
    2018-4546
  • Overview

    This position is responsible for creating and supporting a workflow which identifies and maintains other health insurance information for our Medicare and Medicaid enrollees for the purpose of ensuring proper claims coordination of benefits payments. The candidate will conduct insurance verifications through telephonic or electronic means, ensure accuracy of data, perform updates to the information housed in a central repository, monitor and report changes made to the claims adjudication platforms, and conduct routine audits of other insurance source files.

    Responsibilities

    • Working knowledge of Medicare, Medicaid and Commercial Health Insurance coverage
    • Expert in Coordination of Benefits rules between commercial and governmental payers
    • Ability to make phone calls to other insurance carriers or use online or web based software to complete insurance verifications
    • Able to work independently to complete assignments, assess workflow needs, and manage high volume of verifications
    • Perform timely and accurate updates to other health insurance data
    • Ensures proper order of benefits for claims payment in the claims adjudication systems
    • Collaborates with Management and/or Analytics to identify, report, and correct improper insurance information
    • Performs periodic review of other health insurance coverage for existing and newly enrolled members
    • Understands reimbursement methodologies as they pertain to coordination of benefits

    Qualifications

    MINIMUM EDUCATION REQUIREMENTS

    • Bachelor’s Degree in Business, Finance, Health Administration, Mathematics, or related fields of study preferred. 

    SPECIAL KNOWLEDGE AND/OR SKILLS

    • Previous insurance verification experience in a healthcare setting
    • Demonstrated computer, internet and phone use skills in an office setting
    • Understanding of Microsoft Office Products (Outlook, Excel, Word)
    • Ability to complete assignments in a timely manner.
    • Ability to work independently and manage multiple tasks and priorities.
    • Ability to effectively communicate both verbally and in written form.
    • Collaborates well with others.
    • Exhibits strong attention to detail.
    • Strong documentation and time management skills. 

    WORK BACKGROUND/EXPERIENCE

    • Minimum 1-2 years experience in an insurance verification role in healthcare  

    PHYSICAL REQUIREMENTS

    • Physical health sufficient to meet the ergonomic standards and demands of the position.

     

    About Us

    Virginia Premier is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 

     

    We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  

     

    All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

     

    Our mission is to inspire healthy living within the communities we serve!

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