Insurance Verification Specialist
About The Position
Symbiotic Services is recruiting an experienced, detail-oriented Insurance Verification Specialist for a confidential client in the specialty healthcare industry in the Atlanta, Georgia area. This on-site role verifies patient insurance eligibility, coverage, and benefits before medical services, identifies potential coverage issues, and helps prevent claim denials. The specialist will work with commercial insurance, ACA marketplace plans, Medicare, Medicaid, and other government-sponsored programs, resolving complex eligibility and benefits questions independently. The assignment is temporary and expected to last approximately 6–12 weeks, with potential for permanent placement based on business needs and performance. The position is based in a fast-paced specialty healthcare practice and involves regular collaboration with patient access, scheduling, authorization, billing, and administrative teams. It carries high-volume verification responsibilities requiring accuracy, efficiency, and independent problem-solving. Standard business hours apply; the specific schedule will be confirmed.
Requirements
- Proven experience in medical insurance verification, eligibility determination, or patient access within a physician practice, hospital, or healthcare billing environment.
- Strong knowledge of commercial health insurance, ACA marketplace coverage, Medicare, Medicaid, and other government insurance programs.
- Understanding of insurance premium requirements, grace periods, coverage limitations, and eligibility guidelines.
- Proficiency with electronic insurance verification tools, payer portals, and practice management systems.
- Experience investigating and resolving complex insurance eligibility and benefits discrepancies.
- Strong attention to detail, accuracy, and documentation skills.
- Excellent analytical, problem-solving, and organizational abilities.
- Effective communication and customer service skills when interacting with insurance carriers, patients, and healthcare staff.
- Ability to work independently, manage multiple priorities, and meet deadlines in a high-volume environment.
- Availability to begin work promptly and complete training within the required timeframe.
Nice To Haves
- Previous insurance verification experience in oncology, infusion services, or another specialty healthcare environment.
- Experience using athenahealth or comparable electronic health record (EHR) and practice management systems.
- Familiarity with medical prior authorization processes and insurance approval requirements.
- Experience handling complex insurance benefits and coordination of benefits.
- Background supporting year-end insurance verification and annual benefits renewal processes.
Responsibilities
- Verify patient insurance eligibility, coverage, and benefits before scheduled appointments and medical services.
- Review commercial insurance, ACA marketplace plans, Medicare, Medicaid, and other government-sponsored insurance programs.
- Confirm premium payment status, coverage effective dates, termination dates, and applicable grace periods, particularly for ACA marketplace plans.
- Identify potential coverage gaps, eligibility discrepancies, and financial risks before services are rendered.
- Use electronic eligibility verification systems, insurance carrier websites, and payer portals to obtain coverage information.
- Contact insurance companies when electronic verification results are incomplete, unclear, or inconsistent.
- Investigate and resolve complex insurance issues involving secondary coverage, coordination of benefits, policy changes, terminations, and out-of-network benefits.
- Document verification findings and coverage details accurately in the practice management system.
- Communicate insurance discrepancies and coverage concerns to authorization, scheduling, billing, and financial counseling teams.
- Assist with year-end insurance transitions, annual policy renewals, and new-year benefits verification.
- Communicate professionally with patients and internal staff regarding insurance coverage, eligibility, and benefits.
- Maintain accuracy, confidentiality, and compliance with applicable healthcare privacy requirements.
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What This Job Offers
Education Level
No Education Listed
