Insurance Eligibility Verification Specialist

Great Salt Plains Health Center•Enid, OK

About The Position

The Insurance Eligibility Verification Specialist works in cooperation with the Billing Manager and CFO to verify patient insurance coverage before scheduled medical services. The role ensures eligibility and benefits information is accurately obtained, documented, and communicated to staff and patients to support efficient billing and reimbursement. The specialist also corrects claims with insurance issues and ensures they are rebilled in a timely manner to maximize revenue.

Requirements

High school diploma or equivalent required.
Proficiency in data entry, Excel, word processing, ten-key calculator, and typing required.
Ability to work well in an environment with firm deadlines and be results-oriented.
Ability to organize, communicate, and perform detailed functions.

Nice To Haves

Insurance knowledge preferred.

Responsibilities

Verify patient insurance eligibility and benefits for upcoming appointments using payor portals or by contacting insurance carriers.
Confirm coverage details, including copay, deductible, coinsurance, and coverage limitations.
Enter accurate insurance and eligibility information into the EMR.
Contact patients to obtain missing insurance information.
Train PAS on insurance eligibility.
Identify and resolve insurance eligibility discrepancies before the patient visit, if possible.
Prepare ad hoc projects for management as necessary.
Maintain strict confidentiality and adhere to all HIPAA guidelines and regulations.
Document verification results and maintain detailed records for billing and audit purposes.
Travel to other sites as required; travel may be 10–25%.
Perform other duties as assigned by the Billing Manager.
Correct claims with insurance issues and ensure they are rebilled in a timely manner.