Insurance Verification Specialist

TEKsystems•Minneapolis, MN

18d•$25 - $27•Hybrid

About The Position

The Benefits Insurance Verification Specialist verifies insurance benefits and handles prior authorization for Interventional Urology products, working directly with physician offices regarding surgery coverage. The specialist advocates for customers by coordinating coverage, authorization, and documentation needs, and by communicating reimbursement and access information to office staff and patients. This is a contract-to-hire position based in Minneapolis, Minnesota, with a hybrid schedule of one day in the office and four days remote each week. The stated schedule is Monday through Friday, 8:00 a.m. to 5:00 p.m. Compensation is $25–$27 per hour, depending on experience and other job-related factors.

Requirements

High school diploma.
At least 2 years of experience with medical insurance verification.
Knowledge of insurance benefit verification requirements, guidelines, and policies, including insurance plans requiring pre-authorization.
Experience in a healthcare-related industry.

Responsibilities

Act as an advocate for customers regarding coverage.
Contact insurance carriers to obtain benefit coverage details, policy limitations, authorization or notification requirements, and pre-certifications.
Obtain required authorizations or pre-certifications for patients to access coverage for Interventional Urology products.
Request medical documentation from providers, including nurse case reviewers and clinical staff, to support claims for medical necessity.
Educate customers, staff, and providers about referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance-related changes or trends.
Verify that required prior authorizations are complete and update customers and the customer support team on their status.
Assist in coordinating appeals when required by an insurance payer.
Maintain knowledge of Medicare, Medicaid, and commercial payer requirements, guidelines, and policies.
Communicate reimbursement and access topics clearly and concisely to office staff and patients.
Work with customers when an exception to coverage is needed.
Answer incoming customer and patient calls about the insurance verification process in a professional, knowledgeable, courteous manner.
Perform other duties as assigned by the management team.