Insurance Verification Specialist

Centene Corporation

1d•$16 - $27•Remote

About The Position

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Able to work remote anywhere in the United States, Monday - Friday; 12:00 - 9:00 p.m. EST. Targeted start date for this role is 3/30/26. Position Purpose: Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits. Obtain and verify insurance eligibility for services provided and document complete information in system Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies Collect any clinical information such as lab values, diagnosis codes, etc. Determine patient’s financial responsibilities as stated by insurance Configure coordination of benefits information on every referral Ensure assignment of benefits are obtained and on file for Medicare claims Bill insurance companies for therapies provided Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs Handle inbound calls from patients, physician offices, and/or insurance companies Resolve claim rejections for eligibility, coverage, and other issues Performs other duties as assigned Complies with all policies and standards

Requirements

High school diploma with 1+ years of medical billing or insurance verification experience.
Bachelor’s degree in related field can substitute for experience.

Nice To Haves

Experience with payors and prior authorization preferred.

Responsibilities

Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits.
Obtain and verify insurance eligibility for services provided and document complete information in system
Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
Collect any clinical information such as lab values, diagnosis codes, etc.
Determine patient’s financial responsibilities as stated by insurance
Configure coordination of benefits information on every referral
Ensure assignment of benefits are obtained and on file for Medicare claims
Bill insurance companies for therapies provided
Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
Handle inbound calls from patients, physician offices, and/or insurance companies
Resolve claim rejections for eligibility, coverage, and other issues
Performs other duties as assigned
Complies with all policies and standards