Insurance Verification Specialist

Responsibilities

• Determine patient’s primary, secondary, and tertiary insurance payer.
• Verify patients’ benefits, eligibility, and seek authorization for services by contacting insurance companies.
• Determine patient financial impact and inform them of any possible financial responsibility.
• Timely verification of medical insurance benefits for new patients, existing patients with changes in insurance, and reactivated patients.
• Review and update patient accounts with insurance policy information and process requests accurately.
• Notate each account with a clear summary of patient eligibility and insurance benefits received from the carrier.
• Call government-funded and commercial insurance companies to obtain prior authorizations or referrals.
• Determine the correct Coordination of Benefits.
• Complete verification requests confirming the correct network status through the company’s contracts with insurance payers to determine member benefit coverage.
• Ensure all insurance, demographic, and eligibility information is obtained and entered in the system accurately.
• Review customer files for missing insurance information required to bill for services rendered.
• Perform financial review on existing accounts to identify benefit issues.
• Assist in maintaining inbound faxes, manuals, logs, and other documentation as required.
• Complete insurance verification and summary of reimbursement and liability forms.
• Advise the Manager of verification trends and updates.
• Meet individual, departmental, and company goals.
• Engage in overtime as needed, particularly for high performers or those with demonstrated productivity leadership.
• Conduct business to the highest ethical and professional standards; comply with applicable laws, regulations, and company policies.
• Perform other job duties as assigned.

Requirements

• High school diploma.
• Knowledge of medical terminology.
• Two years’ experience in medical insurance plans or benefit verification practices.
• Excellent written and verbal communication skills.
• Ability to read and understand explanations of medical benefits.

Benefits

• Health and Wellness: Comprehensive medical, dental, and vision insurance plans; company-sponsored wellness programs; mental health resources; paid leave of absence for qualifying events; generous paid parental leave for both birthing and non-birthing parents.
• Financial Security: Competitive 401(k) plan with immediate company match vesting; financial planning services; corporate discount programs.
• Work-Life Balance: Generous paid time off; flexible work hours; flexible work arrangement options.
• Professional Development: Opportunities for continuous learning and career advancement through training programs, mentorship, and tuition reimbursement.
• Recognition and Rewards: Recognition programs including peer recognition, bonuses, awards, and special events.
• Community and Culture: Supportive work environment; team-building activities; volunteer opportunities; company-sponsored events; sustainability strategy.

Pay

The starting hourly rate for this position is $18.28. Hired candidates may be eligible for additional compensation based on applicable experience and may also qualify for bonuses and/or incentives. Actual compensation is influenced by skills, experience, qualifications, and geographic location.