Insurance Support Services Specialist I
About The Position
The Insurance Support Services Specialist I processes health insurance orders by verifying medical coverage, obtaining authorizations, and managing authorization denials and appeals. The role supports compliant and timely billing while providing service to internal and external customers. It includes communicating with patients, providers, and clinicians; maintaining patient confidentiality; assisting accounts receivable staff with unpaid claims related to eligibility or authorization; and performing reimbursement-related administrative duties. The position is based on-site in Durham, North Carolina, during approximately 90 days of onboarding. A hybrid schedule is available after successful onboarding. Work materials, including computers, are provided for business use. During temporary remote-work situations and hybrid work, the employee must maintain a suitable home work environment with reliable, high-speed internet; MED-EL does not cover home-office setup costs.
Requirements
- High school diploma or equivalent.
- Strong mathematical skills for computing and adjusting balances, claims, and billing.
- Experience using health plan portals for verification and authorization.
- Excellent written and verbal communication skills.
- Strong customer service skills for internal and external stakeholders.
- Strong time management, attention to detail, and organizational skills.
- Strong computer, multitasking, and phone skills.
- Critical thinking, creativity, and problem-solving abilities.
- Knowledge of CPT, HCPCS, and ICD-9/10 coding systems.
- Understanding of medical billing software and ability to learn quickly.
- Ability to work well under pressure and with minimal supervision.
- Ability to maintain an appropriate home work environment with reliable, high-speed internet for hybrid work or temporary remote-work situations.
Nice To Haves
- At least 2 years of insurance or revenue cycle experience.
- Experience with insurance verifications, authorizations, denials, and appeals.
Responsibilities
- Answer calls from physician offices, hospitals, and patients while providing exemplary customer service.
- Accurately enter information into databases to support proper and timely claims billing.
- Submit authorizations and verify eligibility according to established procedures.
- Determine member benefit coverage for requested items.
- Communicate with patients and providers about authorization status and any funds due.
- Maintain patient confidentiality in accordance with state, federal, company, and HIPAA requirements.
- Build cooperative working relationships with colleagues, clinicians, patients, and families.
- Support departmental and corporate strategic plans.
- Help accounts receivable staff research unpaid claims involving eligibility or authorization issues.
- Perform daily administrative and general office duties related to reimbursement.
- Use problem-solving and conflict-resolution skills when responding to patient complaints.
- Serve as a resource to clinicians and support staff on authorizations and insurance requirements.
- Maintain knowledge of federal, state, local, and intermediary-specific billing requirements and government regulations.
- Notify appropriate personnel of missing or incomplete billing requirements and follow up promptly.
- Stay informed about coding and reimbursement changes for all payors.
- Perform other reimbursement-related tasks as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
