Insurance Specialist / Full Time / Days

Elevate your career at Wood County Hospital, where you're not just a number – you're a vital part of a team making a real difference.

Insurance Specialist / Full Time / Days

The Insurance Specialist is responsible for ensuring the accuracy, completeness, and integrity of electronic medical records through comprehensive review, verification, and coding of clinical documentation. This role supports high-quality patient care, regulatory compliance, and appropriate reimbursement by validating diagnoses, procedures, and required documentation, managing insurance-related processes, and maintaining departmental quality programs. Through diligent review and collaboration with healthcare providers and administrative teams, the position promotes effective documentation practices and continuous quality improvement. The Insurance Specialist is an onsite position.

Essential Functions

• Review electronic medical records initiated by healthcare providers to ensure documentation supports diagnosis and treatment rendered.
• Schedule and manage Radiation Oncology appointments, including consultations, imaging, simulations, treatments, and follow-ups while monitoring schedules to prevent conflicts and address no-show appointments.
• Examine and validate all components of the medical record for completeness, authorized signatures, patient identification, and required clinical documentation.
• Obtain and manage patient insurance information, including pre-authorizations, claim edits, denials, and appropriate documentation follow-up.
• Communicate and collaborate effectively with patients, families, physicians, and staff by maintaining confidentiality, complying with regulatory requirements, supporting departmental operations, and promoting a positive, organized, team-oriented work environment.
• Prepare, prevent, protect, and respond to support our culture of safety.
• Works hours per week in accordance with offer letter or per attributes of position at transfer request. May be expected to work longer hours as necessary.
• Other duties as assigned.