insurance verification representative

Mac Care

We are seeking a detail-oriented and analytical Insurance Verification &amp; Eligibility Specialist to join our Revenue Cycle team. The ideal candidate will be responsible for verifying patient insurance coverage, determining eligibility, obtaining prior authorizations, and ensuring accurate documentation to support timely claim submission and payment. This role is critical in reducing claim denials, accelerating reimbursements, and supporting overall financial performance in a U.S. healthcare environment.Key Responsibilities: Insurance Verification &amp; Eligibility:<ul><li>Verify patient insurance coverage (commercial, Medicare, Medicaid, and other payers) prior to appointments or services.</li><li>Confirm benefits, deductibles, co-insurance, co-payments, policy limitations, and exclusions.</li><li>Review and interpret payer portals, EHR systems, and clearinghouses for real-time eligibility updates.</li><li>Ensure accurate documentation of verified benefits in the system.</li></ul>Authorization &amp; Pre-Certification:<ul><li>Obtain prior authorizations as required by payers for specific procedures, diagnostic tests, or treatments.</li><li>Communicate with insurance companies to resolve authorization discrepancies or incomplete information.</li><li>Track authorization status and follow up to secure approvals before service dates.</li></ul>Communication &amp; Coordination:<ul><li>Coordinate with providers, schedulers, and billing teams to ensure all insurance-related requirements are met prior to patient appointments.</li><li>Communicate coverage issues, payer requirements, or eligibility concerns to relevant teams promptly.</li><li>Provide guidance to patients regarding coverage expectations, if required.</li></ul>Documentation &amp; Data Accuracy:<ul><li>Maintain complete and accurate patient insurance information in the practice management or billing system.</li><li>Document all interactions, verification results, and authorization details in compliance with organizational policies.</li><li>Identify and correct missing or outdated insurance information.</li></ul>Denial Prevention &amp; RCM Support:<ul><li>Identify potential coverage issues that may result in claim denials.</li><li>Work closely with AR and Billing teams to support clean claim submission.</li><li>Review denial trends related to coverage or eligibility and provide feedback to the team.</li></ul>Qualifications &amp; Requirements:Education:<ul><li>Bachelor&rsquo;s degree preferred, but not mandatory.</li><li>High school diploma or equivalent required.</li></ul>Experience:<ul><li>1&ndash;2 years of experience in U.S. Healthcare Revenue Cycle Management (Insurance Verification, Eligibility, Front-End RCM).</li><li>Experience with commercial insurances, Medicare, Medicaid, and managed care plans preferred.</li><li>Familiarity with EMR systems, clearinghouses, and payer portals.</li></ul>Job Type: Full-timeWork Location: In person

Insurance Verification-Eligibility Specialist

USA Clinics Group

<div>Why USA Clinics Group?
Founded by Harvard-trained physicians with a vision of offering patient-first care beyond the hospital settings, we&rsquo;ve grown into the nation&rsquo;s largest network of outpatient vein, fibroid, vascular, and prostate centers, with 170+ clinics across the country. Our mission is simple: deliver life-changing, minimally invasive care, close to home.
We&rsquo;re building a culture where innovation, compassion, and accountability thrive. While proud of our growth, we&rsquo;re even more excited about what&rsquo;s ahead, and the team we&rsquo;re building to get there. We look forward to meeting you!
Why You'll Love Working with us:
Rapid career advancement Competitive compensation package
Positive, team-oriented environment Work with cutting-ed technology
Make a real impact on patients&rsquo; lives Join a fast-growing, mission-driven company
USA Clinics Group is looking for an organized and motivated individual to join the team as our newest Insurance Verification Specialist! This position performs the function of obtaining referrals, and/or authorizations prior to the service date for test, procedures, and admissions into the clinics.
Position Details:<ul><li>
Location: Northbrook, IL
</li><li>Schedule: Full-Time, Monday-Friday (on-site)</li><li>
Compensation: $23-$26hr based on experience and qualifications.</li></ul>
Responsibilities:<ul><li><ul><li>
Reviews referring physician and patient documentation for Medical Necessity against insurance protocol requirements for pre-certification purposes.</li><li>
Actively communicates with staff regarding status of authorization. Communicates the need for reschedule and/or cancellation if authorization not in-hand).</li><li>
Directs liaison to offices and patients regarding new, changed, or pending insurance authorizations, as well as on-going education of changes in authorization requirements.</li><li>
Responsible for scheduling STAT, emergent patients for outpatient diagnostic exams.</li><li>
Interacts with patients, their representatives, physicians, physician office staff, and others to gather and ensure accuracy of demographic, billing and clinical information.</li><li>
Produces and distributes required forms with accurate patient information.</li><li>
Respects and protects the patient&rsquo;s rights to confidentiality and privacy and discloses information only for the professional purposes which are in the patient&rsquo;s best interests with full consideration of their legal rights.</li><li>
Displays a positive attitude when interacting with provider&rsquo;s office staff, providers and fellow employees.</li><li>
Performs additional duties as assigned</li></ul></li></ul> 
Requirements 
<ul><li>
High school graduate required. Advanced education preferred.</li><li>
Bilingual in English &amp; Spanish required</li><li>
At least 2 years of prior experience in a health care setting handling benefit verification and prior authorizations, required
</li><li>Billing and Coding or other related certifications a plus</li><li>
Strong computers skills and excellent typing skills</li><li>
Immaculate attention to detail and excellent proofreading skills</li><li>
Excellent Customer Service skills</li><li>
Strong data entry skills</li><li>
Excellent organizational skills</li></ul> 

Benefits 
<ul><li>
Health insurance (medical, dental, vision)
</li><li>Retirement Plan
</li><li>Paid time off (PTO) (vacation, sick)</li></ul>
INDM2</div>

Insurance Verification Specialist - Spanish Speaking

LAL Technologies

Job Responsibilities<ul><li>Manage incoming and outgoing calls in a professional and courteous manner</li><li>Address customer inquiries and resolve issues promptly and effectively</li><li>Provide accurate and up-to-date information about products and services</li><li>Maintain and update customer records in the system</li><li>Follow company policies, procedures, and call center standards</li></ul>Requirements<ul><li>Minimum Intermediate qualification (Bachelor&rsquo;s degree preferred)</li><li>Strong communication skills in English</li><li>Excellent listening and problem-solving abilities</li><li>Basic computer proficiency</li><li>Prior call center experience is an advantage (fresh candidates are encouraged to apply)</li></ul>Benefits<ul><li>Competitive salary with performance-based incentives</li><li>Supportive and friendly work environment</li><li>Training programs and opportunities for career growth</li></ul>Work Location: In person

Insurance Verification Agent night

Tuscany Heart & Specialty Surgical Center

JOB SUMMARYThe Patient Access Representative serves as the primary point of contact for patients and visitors, ensuring a professional and welcoming first impression. This role is responsible for managing front-office operations, including answering phones, patient registration, insurance verification, and electronic health record (EHR) maintenance to support seamless patient flow.RESPONSIBILITIES<ul><li>Communication Management: Manage a multi-line telephone system by professionally screening calls, taking accurate messages, and routing inquiries to the appropriate clinical or administrative staff.</li><li>Patient Engagement: Greet patients and visitors upon arrival, verifying identity and demographic information against the daily schedule while providing clear updates on wait times or delays.</li><li>Scheduling &amp; Intake: Efficiently schedule and coordinate appointments within the eClinicalWorks (eCW) EMR system, monitoring emails throughout the day for urgent add-ons or scheduling modifications.</li><li>Insurance &amp; Financial Verification: Conduct comprehensive insurance verification to confirm eligibility, benefits, and coverage requirements prior to service.</li><li>Records Management: Prepare and review patient charts for accuracy and compliance with practice guidelines; digitize medical records by scanning documents directly into the EHR system.</li><li>Administrative Support: Execute various clerical duties and special projects as assigned to maintain operational efficiency.</li></ul>Job Type: Full-timePay: $30,000.00 - $37,000.00 per yearBenefits:<ul><li>Dental insurance</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Education:<ul><li>High school or equivalent (Preferred)</li></ul>Experience:<ul><li>Front Office: 2 years (Preferred)</li></ul>Language:<ul><li>Spanish (Preferred)</li></ul>Work Location: In person

Patient Access Representative

Texas Children's Hospital

<div>We are searching for a Contact Center Representative&mdash;someone who works well in a fast-paced hospital setting. You&rsquo;ll field general inquiries from patients and physicians for information related to scheduled appointments and procedures, insurance verification, My Chart, and customer service needs, confirm correct payer plan, verifies coverage and eligibility, documents authorization requirements and updates demographic information in the EMR, checks referral status, provides information on My Chart enrollment and provides other necessary information to ensure a positive patient experience.
Do you think you&rsquo;re the right person for the job?
<div>Job Duties &amp; Responsibilities
 
<ul><li>Answering inbound or making outbound calls to customers with queries in relation to their account, in a timely, efficient and professional manner
</li><li>Contact Center Pre-Service Insurance Verification Responsibilities
</li><li>Complete and submit required approval forms to responsible party. Ensures the insurance referral has been obtained prior to date of service
</li><li>When applicable prepares estimate for patient out-of &ndash;pocket responsibilities using E-Pro software
</li><li>Responsible for reviewing assigned work queues and prioritizing appointments by day of week and financial risk
</li></ul></div><div>Requirements
 
<ul><li>High School Diploma/GED
</li><li>Two (2) years of contact center, customer service, and/or other experience in a healthcare setting (Associate or Bachelor&rsquo;s degree may be substituted for the experience requirement)
</li><li>Medical scheduling and patient registration knowledge
</li><li>Understanding patient privacy requirements for protected health information (PHI)
</li><li>Basic knowledge of best practice standards for customer service and management of customer expectations
</li></ul></div><div>Preferred:
 
<ul><li>Bilingual: English and Spanish
</li><li>Previous experience with insurance claims filings dealing with Surgery or Radiology
</li><li>Previous experience with Epic helpful</li></ul></div></div>

Contact Center Rep-PreService II

Mercy

<div><div><ul><li>Saint Louis, Missouri</li><li>
Support Services</li><li>
Support Services</li><li>
Regular</li><li>
Part-time</li><li>
Mercy Hospital South</li><li>
JR245173</li></ul><div><div><div><div><div>
</div></div></div></div></div></div><div></div><div><div><h1 class="jobSectionHeader">
Find Your Calling At Mercy!</h1>
The Patient Access Representative is often the first point of contact for our patients and therefore must represent Mercy with the highest standard of customer service, compassion and perform all duties in a manner consistent with our mission, values and Mercy Service Standards. 
 
The Patient Access Representative will facilitate all components of the patient's entrance into any Mercy facility. This may include scheduling, registration, benefit verification, pre-certification and financial clearance including pre-visit collection. The Patient Access Representative will be responsible for ensuring that the most accurate patient data is obtained and populated into the patient record. This co-worker must have an exceptional attention to detail and maintain knowledge and competence with insurance carriers, Medicare guidelines as well as federal, state and accreditation agencies.<h1 class="jobSectionHeader">
Position Details:</h1><h1 class="jobSectionHeader">
Patient Access Representative</h1>
Location: Mercy Hospital South
 10010 Kennerly Rd. St. Louis, MO 63128
Schedule: 
 Part-Time, Evenings
Premium Pay for working in the ED!!<h1 class="jobSectionHeader">
Qualifications:</h1>
Experience and Education Requirements:<ul><li>
Experience: 1-3 years clerical experience preferred. Experience with medical terminology and insurance plans preferred.</li><li>
Education: High School diploma required some college helpful.</li></ul>
Minimum skills, knowledge and ability requirements:<ul><li>
Ability to communicate effectively both orally and in writing, excellent telephone etiquette required.</li><li>
Ability to establish and maintain positive working relationships with patients, physicians, clinical and non-clinical hospital staff and insurance companies.</li><li>
Strong organizational skills; attention to detail</li><li>
Ability to work under stress, meet deadlines and perform all daily assignments with a high level of accuracy.</li><li>
Knowledgeable and experienced with various computers systems; Ability to use a 10-key calculator and computer keyboard.</li></ul>
Physical Requirements:<ul><li>
Position requires the ability to push, pull, and/or lift 50 lbs. on a regular basis.</li><li>
Position requires prolonged standing and walking during each shift.</li><li>
Position requires the ability to grip, reach, bend, kneel, twist, and squat to perform duties.</li></ul><h1 class="jobSectionHeader">
Why Mercy?</h1>
From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
Join a caring, collaborative team where your voice matters. At Mercy, you'll help shape the future of healthcare through innovation, technology, and compassion. As we grow, you'll grow with us.</div></div></div>

Patient Access Representative, Part-Time - Evenings

Crystal Clinic Orthopaedic Center

The Essentials: Schedule: Full-Time (40 hrs/week) | Monday-Friday | Variable Shifts: 7AM-6:30PM Location: Fairlawn, OH Specialties: Central Scheduling, Fast-paced, call-center environment What You&rsquo;ll Do: Serves as a key representative of the organization, providing comprehensive support across patient registration, scheduling, insurance verification, and customer service functions. Register patients accurately to ensure integrity of demographic and insurance data. Verify forms for accuracy and ensure documents are scanned into the EMR. Schedule appointments, including telehealth and specialty visits, following guidelines. Build and maintain EMR cases for insurance, authorizations, referrals, and tracking. Act as a resource for patients, clinical staff, and referring providers, assisting with financial counseling, benefits education, and coordination of services across multiple locations. Answer patient questions and provide accurate, helpful information. Provide strong customer service and represent the organization positively. Performs chart preparation tasks to support upcoming appointments. What We&rsquo;re Looking For: Education: High School or GED required. College degree or progress towards degree preferred. Experience: Prior experience working in a medical office or patient-facing healthcare environment preferred. Minimum of 1 year of customer service, registration, scheduling, or patient access&ndash;related experience strongly preferred. Skills: Strong computer skills and familiarity with office equipment required. Ability to navigate and use Electronic Medical Record (EMR) systems, such as Cerner or Centricity. Ability to learn and train others on scheduling, registration, eligibility verification, and front-desk processes (if applicable to training responsibilities). Proficiency with Microsoft Office applications, including Word, Excel, and Outlook. Build Your Career with Crystal Clinic Orthopaedic Center At Crystal Clinic, people come first&mdash;patients and team members alike. Whether you&rsquo;re starting your career or bringing years of experience, you&rsquo;ll find a supportive environment where you can grow and make a real difference. Join our 5-star team of experts in orthopedics and plastic/reconstructive care, with over 50 board-certified physicians and 15+ locations across Northeast Ohio. What We Offer: Comprehensive Medical, Dental &amp; Vision 100% Employer-Paid Life, Short- &amp; Long-Term Disability 401(k) + PTO Voluntary Pet, Home, and Auto Insurance Benefits Tuition Reimbursement Employee Assistance &amp; Wellness Programs

Patient Access/Central Scheduling (Full-Time)

Search 10000+ Insurance verification representative jobs near you this May. New roles added regularly across leading industries. Apply today.