Lead Insurance Verification Representative

TriasMD•Newport Beach, CA

7d•$27 - $35•Remote

About The Position

TriasMD, the parent company of DISC Surgery Centers, is seeking a Lead Insurance Verification Representative to join our Revenue Cycle team. This is a Monday – Friday, remote position. This role is responsible for performing comprehensive insurance eligibility and benefit verification for scheduled surgical procedures across DISC Surgery Centers. This position will also provide daily operational support to the Insurance Verification team.

Requirements

High school diploma or equivalent required
Advanced knowledge of insurance eligibility, benefit interpretation, patient financial responsibility, and authorization requirements.
Experience with HST, HST Clariti, or comparable healthcare Revenue Cycle systems preferred.
Strong analytical, organizational, problem-solving, and documentation skills.
Excellent communication and patient financial counseling skills.
Ability to prioritize competing deadlines, resolve complex verification issues, support team workflows, and collaborate across departments.
Knowledge of HIPAA, patient confidentiality, and healthcare compliance requirements.

Nice To Haves

Five or more years of healthcare Revenue Cycle experience is preferred, including direct insurance verification experience.
Experience in ambulatory surgery centers (ASCs), hospital outpatient departments, or surgical facilities is strongly preferred.
Prior experience supporting teams or providing training is an asset.
A degree in Healthcare, Business, Finance, or a related field is preferred.

Responsibilities

Verify insurance eligibility for upcoming procedures and communicate financial responsibility to patients
Calculate and document accurate patient financial estimates
Support collection of 90% of eligible collectible estimates before the scheduled procedure.
Maintain accuracy and complete documentation of verification activity within HST
Monitor and escalate financial-clearance concerns.
Collaborate with Authorization staff, facility teams, and Revenue Cycle stakeholders to resolve discrepancies and support timely case readiness.
Manage complex benefit escalations, staff onboarding and training, and coverage as needed.
Maintain knowledge of payer requirements and verification processes, protect patient information and comply with HIPAA and organizational policies.
Perform other duties as assigned.