Insurance Verification Representative - Remote After Training

Emerson Hospital•Concord, MA

30d•Remote

About The Position

The Insurance Verification Representative plays a key role in ensuring patients are financially cleared for urgent and elective services. This position secures prior authorizations, verifies insurance benefits, ensures compliance with payer requirements, and communicates with patients and providers to support a smooth, accurate pre-service process. This role is primarily remote but requires 1-3 months of onsite training at Emerson Health's Concord, MA campus. Once fully trained, you will work independently as part of a virtual business office, collaborating regularly with clinical teams, registration, and financial counseling via phone, email, and messaging platforms. This is an excellent opportunity for someone who enjoys detail-oriented work, problem-solving, and delivering excellent customer service in a fast-paced healthcare environment.

Requirements

Minimum 2 years of experience in healthcare revenue cycle, authorization coordination, or related role requiring strong communication skills
Broad knowledge of government payer programs and insurance requirements
US work authorization required
Strong attention to detail, accuracy, and follow-through
Excellent verbal and written communication skills
Ability to work independently, prioritize tasks, and problem-solve efficiently
Proficiency with Microsoft Office (Excel, Word, PowerPoint, Outlook, SharePoint, Visio)
Ability to quickly learn client workflows, systems, and historical context
Commitment to maintaining compliance with Huron Healthcare standards
Flexibility to work occasional overtime or weekends if needed

Responsibilities

Verify patient insurance coverage and benefits; obtain prior authorizations in accordance with payer requirements
Initiate notices of admission and complete retro-authorizations for urgent or add-on cases when applicable
Communicate with payers, providers, and internal teams to resolve authorization denials, submit additional documentation, and process appeals
Document all authorization activity, payer decisions, reference numbers, and financial conversations in required systems
Notify provider offices of medical necessity issues and coordinate required ABN or Financial Liability forms before the date of service
Submit birth notifications to MassHealth when applicable
Update EMR systems with approvals, status updates, and payer communications
Partner with registration and financial counseling teams to ensure accurate pre-service workflows
Identify and report compliance risks to leadership
Support other revenue cycle activities as assigned