Insurance Verification Specialist
On-site · Sioux Falls, South Dakota, United States
Job Summary
Detail-oriented Insurance Verification and Authorization Specialist to verify coverage, obtain authorizations, communicate financial responsibilities to patients, and collaborate with therapists and billing to ensure payer requirements are met within outpatient rehabilitation services. Responsibilities include verifying insurance coverage (plan types, effective dates, deductibles, co-insurance, out-of-pocket maximums), determining services needing pre-determination or prior authorization, submitting requests, monitoring approvals/denials, providing financial counseling, updating EMR/payer systems, ensuring documentation meets payer requirements, and supporting credentialing activities in a collaborative team environment.
Required Qualifications
- High School Diploma or GED
- Minimum of two (2) years of insurance authorization experience in a healthcare clinic environment
- Experience verifying benefits, obtaining prior authorizations, and working with insurance carriers
- Experience working with individuals with disabilities and/or chronic health conditions
- Familiarity with outpatient rehabilitation services and payer requirements
- All positions require a clear background check and drug screen upon conditional offer
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