Job Opportunities API

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.