Insurance Verification Specialist (DAC)

DERMCARE MANAGEMENT LLC•Boca Raton, FL

About The Position

The Insurance Benefits Coordinator is responsible for verifying patient insurance coverage and accurately determining financial responsibility prior to services rendered. This role is essential to ensuring a seamless patient experience, minimizing claim denials, and supporting the financial health of the practice. The ideal candidate is highly detail-oriented, proactive, and experienced in navigating insurance plans, benefits, and authorization requirements in a fast-paced clinical environment.

Requirements

Previous experience in medical insurance verification required (dermatology preferred)
Strong knowledge of insurance plans, including commercial, Medicare, and Medicaid
Familiarity with CPT/ICD-10 codes and prior authorization processes
Experience with EMR systems (ModMed preferred)
Excellent communication and organizational skills
Ability to manage high-volume workload with accuracy and efficiency
Attention to Detail: Ensures accuracy in benefit verification and cost estimates
Accountability: Takes ownership of patient financial clearance before visits
Communication: Clearly explains insurance coverage and costs to patients and staff
Problem-Solving: Identifies and resolves coverage issues proactively
Efficiency: Works quickly while maintaining high accuracy

Responsibilities

Insurance Verification
Verify patient insurance eligibility and benefits for scheduled services and procedures
Confirm coverage details including deductibles, co-pays, co-insurance, and out-of-pocket maximums
Identify plan limitations, exclusions, and referral requirements
Patient Financial Responsibility
Accurately calculate and communicate patient financial responsibility prior to appointments
Provide clear explanations of benefits and expected costs to patients
Document all benefit details and patient estimates in the EMR
Pre-Authorizations & Referrals
Determine if prior authorizations or referrals are required for procedures
Initiate and track authorization requests to ensure timely approvals
Follow up on pending authorizations to avoid delays in patient care
Coordination with Clinical & Front Desk Teams
Communicate insurance findings and patient responsibility to providers and front desk staff
Ensure schedules are aligned with authorization status and coverage requirements
Collaborate with clinical staff to confirm procedure codes and medical necessity
Claims Support & Denial Prevention
Review benefits prior to service to reduce claim denials and rework
Identify potential coverage issues and escalate as needed
Assist billing team with insurance-related inquiries when necessary
Documentation & Compliance
Maintain accurate and thorough documentation of all insurance verifications
Ensure compliance with payer guidelines and office policies
Adhere to HIPAA and patient confidentiality standards