Insurance Verification Clerk

USPI•Suffolk, VA

11d•$18 - $26

About The Position

Bon Secours Surgery Center at Harbour View is seeking a detail-oriented, customer-focused Insurance Verification Clerk to join its Business Office team. The center is a busy, multispecialty ambulatory surgery center serving the Northern Suffolk community and affiliated with United Surgical Partners International (USPI). The Insurance Verification Clerk supports the revenue cycle and patient experience by verifying insurance, determining eligibility, reviewing benefits, and supporting authorization processes before scheduled procedures. The role works with physician offices, patients, insurance carriers, and internal clinical and administrative teams to collect and document accurate financial and demographic information. Under the direction of the Business Office Manager, the clerk supports operational, financial, and patient satisfaction goals while complying with facility, regulatory, and payer requirements.

Requirements

High school diploma or GED.
At least 2 years of experience in insurance verification, patient access, medical billing, registration, or related healthcare revenue cycle functions.
Strong knowledge of commercial insurance plans, Medicare, Medicaid, managed care organizations, and workers’ compensation benefits.
Experience verifying insurance eligibility and benefits through payer portals, clearinghouses, and direct payer contact.
Excellent verbal and written communication skills.
Strong organizational skills and exceptional attention to detail and accuracy.
Ability to prioritize multiple tasks effectively in a fast-paced healthcare environment.
Proficiency with Microsoft Office Suite, including Word, Excel, Outlook, and Teams.
Ability to maintain confidentiality and professionalism when handling sensitive patient information.
Demonstrated longevity and stability in previous employment.

Nice To Haves

Ambulatory surgery center, hospital, or medical practice experience.
Medical terminology knowledge.
Understanding of CPT, ICD-10, and authorization requirements.
Knowledge of insurance reimbursement methodologies and managed care contracts.

Responsibilities

Verify insurance eligibility, benefits, deductibles, co-insurance, out-of-pocket maximums, and coverage limitations for scheduled surgical procedures.
Obtain and document accurate patient demographic and insurance information in the facility’s practice management system.
Review scheduled procedures to determine authorization and referral requirements.
Coordinate with physician offices and insurance companies to obtain required authorizations and timely approvals.
Communicate with patients about insurance coverage, anticipated financial responsibility, payment expectations, and required documentation.
Review Explanation of Benefits (EOBs), managed care contracts, and payer guidelines to interpret coverage and reimbursement requirements accurately.
Research and resolve insurance discrepancies, eligibility issues, and authorization challenges.
Maintain detailed, accurate records of verification activities and payer communications.
Assist with patient registration as needed, including updating demographic information and obtaining required signatures and documents.
Support collection efforts by identifying patient financial responsibility and communicating payment expectations before surgery.
Collaborate with Business Office, Clinical Leadership, Scheduling, and Physician Office personnel to support efficient patient throughput and customer service.
Maintain compliance with HIPAA regulations and facility policies related to patient confidentiality.
Stay current on payer requirements, insurance regulations, and reimbursement trends affecting ambulatory surgery centers.
Participate in process improvement initiatives to enhance operational efficiency and patient satisfaction.