28 days old

Verification Specialist

Mount Vernon, IL 62864
  • Job Code
Responsible for benefit verification of all insurance coverage for our homecare line of business. Responsibilities include verifying insurance, allowable, pre-certification/pre-authorization, obtaining dispensing orders and confirming the necessary documentation is on file. Work activities include phoning physicians offices for dispensing orders and follow up, releasing order for shipment, review payer specific requirements.

  • Verify eligibility and determine patient benefit coverage and product allowable.

  • Obtain and confirm the necessary dispensing order/ documentation on file.

  • Complete pre-certification/authorization. Obtain additional information such as medical necessity, letter of medical necessity or charts notes to submit for prior authorization.

  • Confirm Authorization/Orders are qualified prior to shipping. Release order for shipping once verification and necessary shipping requirements have been met.

  • Work with vendor billing and reimbursement services to resolve any verification issues as appropriate.

  • Keep updated on all benefit changes for third party insurance carriers within their area of responsibility.

  • Establish and maintain relationships with physician offices and other referral sources.

  • Maintain confidentiality of all information.
Medline offers a business casual, entrepreneurial work environment with strong growth potential, a competitive compensation package, and a complete benefits package including medical/dental/vision/life insurance; 401(k) with company match. And much more!


  • High School diploma or equivalent.
Relevant Work Experience

  • Experience working with verification, documentation and medical records.

  • Experience using time management skills such as prioritizing/organizing and tracking details and meeting deadlines.

  • Experience with MS Office Suite and SAP.
Preferred Qualifications

  • Bachelors degree.
Relevant Work Experience

  • Experience applying knowledge of medical terminology and verification.

  • Certified Coder or experience with medical coding specific to ICD-9/ ICD-10.

  • Experience applying knowledge of HIPAA Privacy and Security Rules and CMS security requirements

  • Experience applying knowledge of Medicare, Medicaid and Commercial payers, its rules and reimbursement

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Verification Specialist

Mount Vernon, IL 62864

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