Insurance Verification and Utilization Review Specialist – Health Services

Community Health and Counseling Services | Bangor, ME, United States

Posted Date 1/10/2025
Full job description

Job Type(s):

Full-Time

Location(s):

Bangor, Maine

Education:

Associates Degree - Business or Secretarial Science

Experience:

Three to Four Years


Job Description

This position will analyze patient insurances and verify eligibility and benefits and determine the primary payor for home health, mental health and hospice services. Obtain prior authorization for payment of services when required from third party payors or managed care companies and determine which payers will require ongoing authorizations, collaborating with Agency staff, patients, family members, facilities and physician. Responsible for utilization management of services, verifying authorization of services throughout patient’s care. Coordination of payor changes as well as claims denial management. Medical Terminology and computer coursework or equivalent required. Working knowledge of medical terminology and healthcare insurance authorization processing. Computer skills including word processing and data entry required. Experience in dealing with internal and external customers in a fast-paced multi-task environment required.

Job IDs: ID #1568

Job Type
Regular
Industry
Healthcare

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