Insurance Verification Specialist
$37,440–$43,680 year
RemoteUnited States
Job Summary
Obtain, analyze, and verify referral and insurance information to ensure clean claim processing and timely billing. Educate patients on financial responsibility and guide them through the verification process while resolving coverage issues and escalating complicated matters to managers. Complete pre-authorizations, process physician orders, and enter accurate demographic and insurance data into EMR databases, including payer requirements and expiration dates. Communicate with insurance carriers and customers via phone or online portals to navigate documentation guidelines and update database systems with new carriers. Maintain HIPAA compliance, complete required training, and assume on-call responsibilities during non-business hours.
Required Qualifications
- High School Diploma or equivalent
- One (1) year of work-related experience in healthcare administrative, financial, or insurance customer services, claims, billing, call center, or management regardless of industry
- Exact job experience is considered any of the above tasks in a Medicare-certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance
- Must be able to bend, stoop, stretch, stand, and sit for extended periods of time
- Must be able to lift 5 to 10 pounds periodically as needed
- Excellent ability to effectively communicate both verbally and in writing with customers, demonstrating empathy, compassion, courtesy, and respect for privacy
- Mental alertness to perform the essential functions of the position
- Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form
Desired Qualifications
- General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred
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