Insurance Verification Specialist
About The Position
The Insurance Verification Specialist performs quality assurance reviews of individual insurance policy benefits before insurance verifications are released to clinical teams. The role reviews patient accounts against verified benefits, documents coverage patterns, and develops templates and job aids for the verification team. It collaborates with department teams to support a seamless patient financial lifecycle and maintains knowledge of clinical patient financial processes and their connections to revenue cycle processes. The specialist maintains proficiency with insurance verification forms, protocols, procedures, websites, and proprietary software. The role also serves as a customer service resource for clinical teams seeking guidance on insurance benefits and patient financial matters, performs verification calls and web-portal tasks as needed, and supports pre-certification work when needed. The team member is expected to uphold company policies, confidentiality, compliance, and professional standards, and may perform related duties and assist with projects as needed.
Requirements
- At least 2 years of insurance verification experience.
- Strong knowledge of insurance benefits and insurance terminology.
- Exceptional verbal and written communication skills.
- Strong attention to detail and organizational skills.
- Solution-oriented approach to problem-solving.
- Proficiency in Microsoft Office.
Responsibilities
- Perform quality assurance reviews and analysis of individual insurance policy benefits before verifications are released to clinical teams.
- Document and use insurance policy coverage patterns to create templates and job aids for the verification team.
- Review patient accounts against verified insurance benefits to ensure accurate coverage.
- Collaborate with other department teams to support a seamless patient financial lifecycle.
- Maintain knowledge of the clinical patient financial lifecycle and its intersections with clinical and revenue cycle processes.
- Maintain proficiency in insurance verification forms, protocols, procedures, websites, and proprietary software.
- Provide clinical teams with customer service, guidance, and explanations regarding patient insurance benefits and financials.
- Perform insurance verification phone calls and web-portal tasks as needed.
- Participate in pre-certification tasks as needed.
- Notify management of unusual scenarios, possible compliance concerns, or recurring issues.
- Maintain a positive and professional work environment.
- Support compliance, privacy and confidentiality, protection of organizational assets, ethical conduct, reporting non-compliance, and adherence to applicable laws, regulations, accreditation and licensure requirements, and company procedures.
- Perform other related duties and assist with project completion as needed.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
