Insurance Verification Specialist

We are seeking a detail-driven and proactive Medical Insurance Verification Specialist to join our growing healthcare team. The ideal candidate will act as the crucial link between patients, providers, and payers, ensuring accurate insurance coverage verification, obtaining prior authorizations to reduce claim denials.

• Verification & Eligibility: Perform high-volume, real-time insurance verification for new and existing patients via payer portals and phone calls.
• Prior Authorization: Initiate, follow up on, and obtain necessary prior authorizations and referrals for scheduled services.
• Documentation: Accurately document all benefits—including deductibles, out-of-pocket maximums, copays, and co-insurance—directly into the EHR/Practice Management System.
• Patient Communication: Proactively inform patients of their financial responsibilities (deductibles, copays) prior to their appointment on some occassions
• Problem Solving: Investigate complex coverage issues and coordinate with providers to ensure seamless billing.
• Technology Utilization: Knowledge of online payer portals (e.g., Availity, Medicare) to maximize efficiency.

Required Qualifications & Skills

• Experience: Minimum 1-2 years of experience in medical insurance verification, billing, or scheduling, preferably in a specialty clinic or hospital setting.
• Technical Skills: Proficiency in EMR/EHR systems and Microsoft Office (Excel, Word, Outlook).
• Knowledge: Strong understanding of medical terminology, CPT/ICD-10 codes, and various payer structures (Medicare, Medicaid, Commercial HMO/PPO).
• Communication: Excellent verbal and written communication skills for interacting with insurance plans and patients.
• Attention to Detail: Exceptional analytical skills to identify gaps in coverage and data inconsistencies.

Benefits:

• Medical Insurance
• 401K
• PTO
• Paid Holidays
• Hourly Wage depending on experience
• M-F 9 am-5 pm or 8:30 am-4:30 pm

Please send resume and a short cover letter to [email protected]