Job Description 

IBV QA Specialist

Enjoy what you do while contributing to a company that makes a difference in people’s lives. US Fertility (USF), one of the premier networks of fertility practices in the United States, continually seeks experienced, compassionate, and dynamic team players who are committed to delivering exceptional work to join our growing network. The work we do building families offers stimulation, challenge, and personal reward.

OVERVIEW: The IBV QA Specialist is responsible for maintaining the efficacy and quality of the insurance benefit verification process for US Fertility. This position will serve as the liaison between the IBV centralized team and the practices, ensuring that benefits are completed within benchmark and accuracy. The schedule is working M-F 8:00am-5pm working Remotely.

​How You'll Contribute: 

We always do whatever it takes, even if it isn’t specifically our “job.” In general, the IBV QA Specialist is responsible for:

JOB DUTIES:

Oversee and audit the insurance verification workflow process completed by assigned team members. Insurance entry in NextGen, to include policy ID #, group #, and copy insurance card. IBV details completed in NextGen and EMR system. IBV sent to patient through the patient portal. Ensure that IBVs are completed within benchmark goals (5 business days before NPV and 2 business days for IBV Request reverification). Perform audits on patient accounts to ensure benefits are verified correctly. General benefits Coverage Limitations (lifetime max, non-covered services, etc.) PCP referral requirements Authorization requirements Enrollment in case management services Meet with assigned team on a weekly basis to provide feedback on audits and training opportunities. Participate in team and leadership meetings to discuss audits and implementation of best practices. Provide monthly feedback on the following: # of NPs scheduled # of NPs kept # of IBVs completed prior to NP visit Create and maintain documentation on all insurance verification and billing procedures, to include updates from insurance, current state, federal, and company policies, procedures, and regulations.  Handle and resolve all incoming IBV related inquiries from assigned USF practices. Serve as a backup as IBV specialist as needed. Provide courteous and professional customer service to patients, coworkers and management.  Exceptional people skills. Genuine team player that maintains an excellent rapport and working relationship with all members within department and clinical and operations teams at the local offices.  Strong verbal, written, and interpersonal communication skills are a must. Communicates effectively with patients, coworkers, and supervisors.   Outstanding follow-through, self-directed and highly motivated with a strong sense of urgency.  Meticulous attention to detail.   Able to manage time effectively.  Follows all policies and procedures.               

EDUCATION AND QUALIFICATIONS: 

High school diploma and at least two years of medical business office experience including insurance procedures, patient interaction, and health records systems experience required. Associates or Bachelors degree in Business Administration or related field preferred. Experience working in a healthcare field, preferably in a clinical setting or business office is required. Insurance knowledge requirements including: Understanding of medical terminology Managed care authorization process ICD9 and CPT codes Computer literacy required. Ability to access, input, and retrieve information from a computer and proficient with a variety of hardware and software applications

More important than the best skills, however, is the right person. Employees who embrace our mission, vision, and core values are highly successful.  

What We Offer:

Competitive pay + bonus Comprehensive training Medical, dental, vision, and 401(k) matching Generous paid time off and holidays Retirement plan Tuition assistance Ability to make an impact in the communities we serve

US Fertility is an Equal Opportunity Employer that values a diverse workplace. We are committed to building a team that is inclusive of all people, including those of LGBTQIA+ communities, members of all ethnic groups, people with disabilities and medical conditions, foreign-born residents, and veterans. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. US Fertility is also committed to compliance with all fair employment practices regarding citizenship and immigration status.

To learn more about our company and culture, visit here.

How To Get Started:

To have your resume reviewed by someone on our Talent Acquisition team, click on the “Apply” button. Or if you happen to know of someone who might be interested in this position, please feel free to share the job description by clicking on an option under “Share This Job” at the top of the screen.