Insurance Verification and Authorization Specialist

Job Title: Insurance Verification & Patient Account Specialist

Position Summary

The Insurance Verification & Patient Account Specialist is responsible for ensuring accurate eligibility verification, benefits review, and patient account integrity. This role requires strong knowledge of insurance guidelines, excellent communication skills, and the ability to resolve discrepancies efficiently while delivering exceptional customer service to patients and payers.

Key Responsibilities

• Verify patient eligibility and benefits with insurance carriers prior to services rendered.
• Review patient accounts for accuracy and completeness; obtain and document any missing information.
• Maintain thorough knowledge of insurance guidelines, including HMO, PPO, Medicare, and state Medicaid plans.
• Contact insurance companies to resolve discrepancies identified during the verification process, including coordination of benefits issues.
• Provide exceptional customer service when interacting with patients and family members regarding medical claims, billing questions, and payment arrangements.
• Research and resolve account discrepancies, denials, appeals, and collection-related matters.
• Document all account activity accurately and thoroughly within the practice management system.
• Collaborate effectively within a team environment to support overall revenue cycle goals.

Required Skills & Qualifications

• Working knowledge of medical terminology related to medical claims and billing.
• Strong understanding of insurance plan structures (HMO, PPO, Medicare, Medicaid).
• Excellent verbal and written communication skills.
• Strong customer service orientation with the ability to work with diverse patient populations.
• Proven problem-solving and critical-thinking abilities.
• Ability to multitask and manage assigned accounts efficiently.
• Detail-oriented with strong organizational skills.
• Ability to work independently as well as in a collaborative team setting.

Preferred Experience

• Minimum 1–2 years of experience in medical billing, insurance verification, or revenue cycle operations.
• Experience working within a physician group or specialty practice preferred.
• Familiarity with electronic health record (EHR) and practice management systems.

Education and experience required: Must be familiar with Vytera, Intergy and Greenway Practice Management Systems as well as Insurance website for verification purpose.

Job Type: Full-time

Pay: $18.00 - $21.00 per hour

Work Location: In person