Verification Specialist

XCELL ORTHOPAEDICS INSTITUTE OF SPORTS PERFORMANCE•McAllen, TX

2d•Onsite

About The Position

The Verification Specialist plays a critical role in ensuring the accuracy and integrity of insurance claims and billing processes within a high-volume call center environment. This position involves conducting thorough outbound calls to verify patient information, insurance coverage, and claim details to facilitate timely and accurate medical and auto insurance claim processing. The specialist will collaborate closely with medical billing teams and insurance providers to resolve discrepancies and prevent claim denials. By maintaining detailed and precise records through data entry, the Verification Specialist supports the overall revenue cycle management and enhances customer satisfaction. Ultimately, this role contributes to the efficient handling of claims, reducing errors and improving the financial performance of the organization.

Requirements

Proven experience in a high-volume call center environment with outbound calling responsibilities.
Knowledge of medical billing, medical claims processing, and medical insurance procedures.
Familiarity with medical terminology and auto insurance claim processes.
Strong data entry skills with high attention to detail and accuracy.
Ability to communicate clearly and professionally with patients, providers, and insurance representatives.

Nice To Haves

Experience working specifically with medical insurance verification and claims adjudication.
Certification or training in medical billing or coding.
Proficiency with electronic health record (EHR) systems and claims management software.
Background in customer service within the healthcare or insurance industries.
Demonstrated ability to manage multiple tasks efficiently in a fast-paced environment.

Responsibilities

Perform outbound calls to patients, healthcare providers, and insurance companies to verify insurance coverage and claim information.
Review and process medical and auto insurance claims, ensuring all data is accurate and complete according to medical terminology and billing standards.
Maintain detailed and accurate records of all verification activities and data entries in compliance with company policies and regulatory requirements.
Collaborate with internal teams such as billing, claims processing, and customer service to support efficient claim resolution and payment processing.