Rev Cycle Insurance Verification Specialist
Aliso Viejo, CA

Why work with Mnet Health Services?

Your next career move should be with one of the most successful companies in the healthcare field today; that’s Mnet Health Services. During the long financial crisis, both healthcare and financial services prospered and even now continue to thrive. Come and experience a truly rewarding career in an industry where income potential and job stability are simply unmatched.

Serving more than 600 satisfied healthcare providers nationwide, Mnet Health has created opportunities for you to profit from a field that offers truly unlimited earning and growth potential. Mnet Health has created financial services results for the health care industry that are both exciting and cutting-edge solutions; including the development of online and software products tailor-made for the world of healthcare.

What is the role?

This supports our valued clients who need outsourced professionals.

Responsibilities include:

  • Supporting centralized business offices, ambulatory surgical centers or hospitals to determine and verify third party (i.e. insurance carrier or government payor) benefits. This includes reviewing insurance sites and contacting 3rd party payors.
  • Seek pre-certification prior to services being rendered.
  • Following up with parties within client’s entity in order to secure needed information and documentation necessary for authorization. This includes obtaining referrals and authorizations.
  • Auditing patient files in client’s EHR (electronic health records) or EPM (electronic practice management) software to ensure accuracy and completeness of all required items for the revenue cycle management process are in place.
  • Assist client to resolve eligibility issues.
  • Document all conversations, authorizations and information related to work performed by this role.
  • Work with client to establish estimated out of pocket expense to the patient or responsible party.

All work performed follows guidelines for legal compliance of state and federal laws regarding healthcare, medical billing and collections.

Salary and incentive structure will depend upon experience and fit for role. Please be aware that this is a non-management role within the organization.

What type of candidates do we seek?

  • Attention to detail is critical for this position. We only provide value to our clients if we perform our duties accurately.
  • We need a dedicated team member who is intelligent, learns quickly, likes challenges, able to solve problems, demonstrates flexibility, high energy, team player, demonstrates good judgment and possesses a high level of integrity.
  • Knowledge of revenue cycle management process, insurance verification, insurance/government payor knowledge (commercial insurance, Medicare and Medicaid), medical terminology, EHR software and ERP software from prior work in medical office/hospital/insurance setting or educational experience.
  • Strong verbal and written communication skills are a must. Fluent bilingual Spanish/English is a plus.
  • Must be able to multi-task, prioritize and remain organized so that they may work semi-autonomously. This includes using time wisely in order to perform functions in a timely manner.
  • Excellent 10-key and typing skills are a must.
  • We also require intermediate math, Microsoft Office and typing skills.
  • Ideal candidate will have 2+ years healthcare payment posting experience.
  • Requirement of a minimum of high school diploma or GED.