Insurance Verification Specialist I - REMOTE

Community Health Systems Professional Services Corporation • Belspur, FL

1d • Remote

About The Position

The Insurance Verification Specialist I verifies insurance eligibility and benefits, confirms authorization requirements, and completes pre-registration for scheduled outpatient and inpatient services. The role supports financial clearance by ensuring compliance with payor guidelines, communicating accurately and promptly with patients, providers, and medical office staff, and educating patients about coverage and financial responsibilities. This is a remote position supporting the Sarasota SSC, which provides revenue cycle services to hospitals and patients.

Requirements

• High school diploma or GED.
• 0–1 years of experience in insurance verification, medical billing, or healthcare revenue cycle.
• Strong knowledge of insurance plans, authorization requirements, and medical necessity guidelines.
• Proficiency in Microsoft Office Suite and healthcare information systems, such as EMR systems and eligibility portals.
• Excellent attention to detail and organizational skills.
• Strong communication and interpersonal skills for interacting with patients and healthcare professionals.
• Ability to work in a fast-paced environment and manage multiple priorities effectively.

Responsibilities

• Verify insurance eligibility and benefits for scheduled and unscheduled services.
• Calculate and communicate patients’ estimated financial responsibility for scheduled services.
• Identify and ensure authorization and referral requirements are met according to payor guidelines.
• Validate and document authorizations and referrals according to established policies.
• Review scheduled services and determine medical necessity based on payor criteria.
• Accurately document and maintain required records and communications in accordance with organizational standards.
• Communicate professionally with patients, physicians, and medical office staff to resolve inquiries and support compliance with payor requirements.
• Educate patients about insurance coverage, benefits, and financial responsibility.
• Process and index incoming orders promptly and comply with documentation standards.
• Provide timely notification of admission or observation status according to payor guidelines for inpatient and observation services.
• Perform other duties as assigned and comply with all policies and standards.

Benefits

• PTO
• Paid holidays
• Employee Incentive Program (ICP)
• Group medical, dental, and vision coverage
• Educational assistance
• 401(k) plan
• Sick time
• Life insurance and accidental death and dismemberment coverage
• Long-term and short-term disability
• Medical and child care flexible spending accounts
• Employee Assistance Program (EAP)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED