Spanish Bilingual Insurance Verification Specialist

Position Title: Spanish Bilingual Insurance Verification Specialist

Salary Grade: 

Reports To: Partner, Partner Advisor

Primary Relationships: Partner Team

Date: August 2023

Schedule: 9:00 PM to 6:00 AM PH Time

Responsibilities:

• Verify insurance information and accurately organize documentation.

• Obtain prior certifications and referrals, emphasizing the inclusion of ultrasounds for new patients

• Document copays, deductibles, out-of-pocket expenditures, and virtual benefits in comprehensive notes

• Assess eligibility for prepayment plans, schedule payments, and manage existing payment plans

• Proactively offer one-time payment discounts for balances below $500

• Ensure insurance policies are active and up-to-date

• Secure prior authorizations when required, tracking associated physicians and ensuring comprehensive visits

• Maintain records of authorization effective periods to prevent lapses

• Ensure accuracy of policy status, including effective and termination dates.

• Coordinate benefits efficiently

• Demonstrate proficiency in distinguishing between types of insurance plans (MCR, HMO, PPO, etc.)

• Manage considerations for in-network and out-of-network services (e.g., clinic restrictions, dialysis)

• Thorough understanding of payable benefits, including copays, deductibles, coinsurances, and out-of-pocket limits

• Familiarity with referral, precertification, and authorization requirements

Qualifications:

• Fluent in both English and Spanish (Bilingual proficiency)

• Minimum of 3-5 years of experience in insurance verification

• Proficiency in using Epic software

• Excellent verbal and written communication skills

• Strong attention to detail and accuracy

• Thorough knowledge of Medicare replacement plans and their operational dynamics

• Experience dealing with private insurances and managed care systems

• Computer literacy with the ability to navigate software systems effectively

• Minimum typing speed of 50 words per minute

• Sound understanding of medical billing processes and terminology

• Familiarity with telemedicine concepts

• Ability to quickly adapt to new processes and technologies

COmpany Benefits:

• SSS, Philhealth, Pag-Ibig

• 13th Month Pay

• HMO and Life Insurance (AVEGA)

• Free Shuttle Service

• CO League - Monthly Company Activities

• CO Clubs

• CO Amenities Swimming Pool, Clinic and Kids zone

• CO Stars - Corporate Social Responsibility Involvement Scholarship Programs

• CO Academy - Training and Development Programs

• COolture Coach

• CO Gears

• Cool and Flexible Workplace

• Other Performance and Attendance Based Rewards

• Bereavement Leave

• Paternity Leave

• 7 days SOLO Parent Leave

• Magna Carta Leave

• Company Bank Loan