Insurance Verification Representative - Tennova MultiSpecialty Clinic - Alcoa

Community Health Systems•Knoxville, TN

About The Position

The Insurance Verification Representative accurately verifies patient insurance coverage, benefits, and eligibility to support proper reimbursement and prevent service delays. The role coordinates with physician offices, case management teams, and financial counseling to facilitate pre-certifications, authorizations, and patient financial obligations. It contributes to accurate patient account liability, reduced denials, and improved revenue cycle efficiency. The position offers 8-hour shifts during the hours of operation, Monday through Friday, 8:00 a.m. to 5:00 p.m. Weekends, holidays, and call are not required.

Requirements

0–2 years of experience in insurance verification, medical billing, or patient access in a healthcare setting.
Strong knowledge of insurance verification, pre-authorizations, and patient financial services.
Proficiency with healthcare insurance terminology, including co-pays, deductibles, out-of-pocket costs, and covered services.
Ability to interpret and apply insurance policies and payer guidelines to verify eligibility and benefits accurately.
Effective communication and customer service skills for professional interactions with patients, physician offices, and insurance providers.
Strong organizational and time-management skills, including the ability to handle multiple verification requests efficiently.
Proficiency with electronic health record systems, payer websites, and insurance portals for eligibility verification.
Understanding of HIPAA regulations and patient privacy requirements when handling sensitive financial and insurance information.

Nice To Haves

2–4 years of insurance verification experience in an acute care hospital or physician practice group.
Experience with electronic health records, insurance portals, and revenue cycle workflows.
CHAA (Certified Healthcare Access Associate) certification.

Responsibilities

Verify insurance benefits, eligibility, and pre-determination requirements for scheduled patients before services are rendered.
Coordinate with physician offices to obtain required pre-authorizations and pre-certifications.
Confirm coverage for procedures and treatments, documenting insurance details, policy limitations, and reimbursement expectations.
Initiate financial counseling for uninsured or underinsured patients and refer them to financial assistance programs or payment plan options.
Document and update patient records, including pre-certification numbers, eligibility details, and authorization statuses.
Communicate with patients and physician offices about coverage, financial responsibilities, and payment expectations.
Enter pre-registration documents into the electronic health record in a timely manner and forward them to the appropriate department.
Maintain accurate department records, reports, and documentation in compliance with billing, regulatory, and facility policies.
Identify and resolve insurance discrepancies that could result in billing errors or claim denials.
Collaborate with case management, patient registration, and billing teams to support revenue cycle operations and reimbursement.
Perform other duties as assigned.
Maintain regular and reliable attendance and comply with all policies and standards.