insurance verification representative

Cardiac Rhythm Specialists, Inc.

Job Summary We are seeking a proactive and detail-oriented Insurance Verifier with at least 3 year experience to join our team. In this vital role, you will be responsible for verifying patient insurance coverage, ensuring accurate and timely processing of insurance information, and facilitating smooth billing operations.Responsibilities<ul><li>Verify daily patient insurance coverage by contacting insurance companies and reviewing electronic or paper records</li><li>Confirm patient eligibility, benefits, and authorization requirements prior to service delivery</li><li>Accurately document insurance details using CPT (Current Procedural Terminology), ICD (International Classification of Diseases), and other relevant coding systems such as ICD-9 and ICD-10</li><li>Collaborate with medical office staff to resolve discrepancies or issues related to insurance verification</li><li>Stay updated on managed care policies, insurance plan changes, and coding guidelines to ensure precise verification processes</li></ul>Qualifications<ul><li>Prior experience at least 3 yr experience in a medical office setting or dental office environment is highly preferred</li><li>Strong knowledge of managed care systems, medical terminology, and insurance verification procedures</li><li>Familiarity with HIPAA regulations to ensure patient privacy and data security</li><li>Experience with CPT coding, ICD coding (ICD-9, ICD-10), and medical records management</li><li>Excellent communication skills for liaising with insurance companies and healthcare providers</li><li>Office experience demonstrating organizational skills and ability to multitask and work effectively as a team.</li></ul>Pay: $20.00 - $24.00 per hourBenefits:<ul><li>401(k)</li><li>Health insurance</li></ul>Work Location: In person

Insurance Verifier

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

Brite Health Care

Stable Durable Medical Equipment (DME) Company is ready to expand its medical insurance verification team.You must live in Katy or West Houston for this position!We are a high volume health care company looking to welcome the right person for this challenging and fast-paced position as an Experienced Insurance Verification Specialist within our well-established company.This is not an entry-level position so the ideal candidate will have at least 2 years&rsquo; experience with medical insurance verification related to DME items.***PLEASE NOTE***For this position, insurance verification does not mean checking to see if a patient has insurance or if the insurance is current.In this position, you must check to see what DME benefit coverage the plan offers, determine the patient&rsquo;s deductible and Out-of-Pocket status, and if the DME items on order require authorization before they can be approved. Employee must get insurance authorization for those plans that require this extra step.Must Possess:<ul><li>Knowledge of ICD10, HCPCS Codes, and medical terminology</li><li>Experience contacting insurance providers, determining coverage benefits as well as deductible status</li><li>Familiarity with various insurance plans and respective verification portals</li><li>High attention to detail and accuracy</li></ul>Must Be:<ul><li>Computer literate</li><li>Driven to perform at a high level</li><li>Professional</li><li>Articulate</li><li>Able to work well with others</li></ul>Must Have:<ul><li>Polite phone etiquette; customer service oriented</li><li>10 key experience a plus, type at least 45wpm</li><li>Knowledge of medical billing coding</li><li>Dependable Transportation</li><li>High school or equivalent education</li></ul>Bilingual in English/Spanish a plus.This is a full time, hourly position with health, dental, vision insurance benefits as well as paid time off. Please send your resume and references. Salary range is $13.00 - $18.00 per hour. This position offers substantial growth opportunity. Again, this is not an entry level position. Only well qualified candidates, living in Katy or West Houston, will be considered.Office hours are Monday through Friday 8:30 to 5:00.Reply to HRRecruiters, please don't contact us! Do NOT contact us with unsolicitedservices or offersJob Type: Full-timePay: $13.00 - $18.00 per hourBenefits:<ul><li>Dental insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: In person

Experienced DME Insurance Verification

Tennessee Orthopaedic Alliance

<div>Description:

Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Nashville, Middle Tennessee and East Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state.
There are a number of reasons why TOA is an employer of choice; here are a few of them:<ul><li>
Stability- TOA has been in Middle Tennessee since 1926!</li><li>
Impact- TOA&rsquo;s team members use our careers &ndash; whether in our clinics or our business office &ndash; to make a positive difference in the community by building relationships and helping patients live their best life.</li><li>
Work Environment- The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement.</li><li>
Total Rewards- TOA offers competitive salaries based off the area's wage market, plus a comprehensive suite of benefits, including Medical, Dental, Paid Time Off, and more. Our 401(k) plan provides a company match, safe harbor match and profit sharing match to go along with your contributions.</li></ul>
The Insurance Verification Specialist is responsible for the timely verification of medical insurance benefits. Day-to-day activities may include all or some of the essential functions listed below depending upon individual experience / knowledge and the needs of the organization which are subject to change from time to time.<ul><li>
Utilizes the Workflow Daily Appointment Report for your site as a primary source for insurance verification and determining insurance compatibility with TOA&rsquo;s managed care plans.</li><li>
Adhere to best practices standards in performing day-to-day follow-up tasks.This includes following procedures outlined in the &ldquo;VOI Training/Procedure Manual&rdquo;.</li><li>
Place phone calls to patients, patient&rsquo;s family/significant other, insurance companies, and facility personnel in an attempt to acquire information necessary to verify.</li><li>
Responsible to resolves any issues with coverage, referrals, precertification and escalate complicated issues to the immediate manager.Also must have a basic knowledge and understanding of what a referral and an authorization are.</li><li>
Enters and ensures information in the insurance fields is correct to its entirety.If incorrect, information in the system must be updated appropriately. This includes moving any VOB&rsquo;S, authorizations and clinical referrals.If encounters were billed incorrectly to a now corrected insurance, you must email collections so claims can be rebilled if needed.</li><li>
Familiar with a variety of the facility concepts, practices, and procedures. Relies on experience and judgment to plan and accomplish goals.</li></ul>
Requirements:
<ul><li>High school diploma required</li><li>
2-4 years of experience in insurance verification preferred</li><li>
Must have experience reading and understanding payer eligibility electronic returns, and the ability to differentiate between insurance plans, copay, deductible, and coinsurance</li><li>
Requires accuracy, attention to detail, ability to follow directions, and organization skills</li></ul>
TOA is an equal opportunity employer. TOA conducts drug screens and background checks on applicants who accept employment offers</div>

Insurance Verification Specialist - PRN

Macrise Tech Solutions

We are looking for a highly organized and detail-focused Insurance Verification &amp; Authorization Specialist to join our medical billing team. This role is essential in ensuring accurate patient insurance verification, securing timely prior authorizations, and maintaining complete and compliant documentation to support efficient billing and claims processing.The ideal candidate will possess strong communication skills, exceptional attention to detail, and a thorough understanding of payer requirements, with the ability to perform effectively in a fast-paced healthcare environment.Key ResponsibilitiesInsurance Verification &amp; Eligibility<ul><li>Verify patient insurance coverage through payer portals and direct communication with insurance providers.</li><li>Maintain accurate and up-to-date eligibility records within the Electronic Health Record (EHR) system (e.g., eClinicalWorks).</li><li>Complete and upload insurance verification documentation promptly for all newly registered patients.</li><li>Clearly explain estimated patient financial responsibilities, including copayments, deductibles, and out-of-pocket expenses.</li><li>Escalate unresolved eligibility discrepancies or coverage issues to the Patient Collections team when required.</li><li>Proactively follow up with patients to obtain missing, corrected, or updated insurance information.</li></ul>Authorizations &amp; Compliance<ul><li>Obtain prior authorizations for medical and behavioral health services requiring insurance approval.</li><li>Ensure compliance with Medicaid and other payer-specific authorization guidelines and policies.</li><li>Coordinate with the Patient Services team to manage out-of-network insurance cases.</li><li>Secure authorizations for psychological assessments while maintaining accurate documentation and system alerts.</li></ul>Operational Support &amp; Collaboration<ul><li>Assist with urgent or same-day appointment scheduling as needed.</li><li>Track and communicate updates related to payer policies, billing concerns, and provider network participation.</li><li>Collaborate with the Practice Manager to resolve incomplete or inaccurate patient intake documentation.</li><li>Participate in team meetings to enhance workflow efficiency, improve data accuracy, and support continuous process improvement.</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs70,000.00 per monthAbility to commute/relocate:<ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift in Wapda Town, Lahore?</li></ul>Experience:<ul><li>Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Insurance Verification (VOB)-Medical Billing

Inner Illumination Therapy and Counseling, LLC

Overview Join our dynamic healthcare team as an Insurance Verification Specialist, where your expertise will be essential in ensuring seamless insurance processing and patient care. In this vital role, you&rsquo;ll be the first point of contact for verifying patient insurance coverage, managing medical records, and coordinating with insurance providers to facilitate accurate billing and reimbursement. Your energetic approach and attention to detail will help streamline operations and support our mission of delivering exceptional healthcare services.Responsibilities<ul><li>Verify patient insurance coverage accurately by contacting insurance companies and reviewing policy details.</li><li>Obtain pre-authorizations and referrals as required by managed care plans to ensure timely patient access to services.</li><li>Review and update medical records, ensuring all documentation complies with HIPAA regulations and confidentiality standards.</li><li>Utilize medical terminology, CPT coding, ICD-9, ICD-10, and ICD coding to interpret clinical information for billing purposes.</li><li>Communicate effectively with medical offices, dental offices, and other healthcare providers to confirm patient eligibility and coverage details.</li><li>Maintain detailed records of insurance verification activities, updates, and correspondence for audit readiness.</li><li>Collaborate with the billing department to resolve any discrepancies or issues related to insurance claims or coverage.</li></ul>Requirements<ul><li>Proven experience in medical office administration or healthcare insurance verification.</li><li>Strong knowledge of managed care processes, medical terminology, and medical coding systems including CPT, ICD-9, ICD-10, and ICD coding.</li><li>Familiarity with HIPAA regulations to ensure patient privacy and data security at all times.</li><li>Prior office experience in a healthcare setting, preferably in dental or general medical offices.</li><li>Excellent communication skills for liaising with insurance companies, healthcare providers, and patients.</li><li>Ability to handle sensitive information with professionalism and accuracy.</li><li>Knowledge of medical records management and insurance verification procedures is highly desirable. Embrace this opportunity to energize your career while making a meaningful difference in patient care! We&rsquo;re dedicated to fostering a supportive environment where your skills thrive as you help us deliver top-tier healthcare services efficiently and confidently.</li></ul>Pay: $23.81 - $28.67 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Flexible schedule</li><li>Health insurance</li><li>Paid time off</li><li>Professional development assistance</li></ul>Work Location: Remote

Insurance Verification Specialist

AssistRx

<div>
 
 Job Description:
 
 The purpose of this position is to
 
 help patients get access to the medications
 
 and therapies that they need.
 
 
 
 Job Details Snapshot:
 
 
 
 <ul>
 <li>
 Compensation: $19-22/hr
 </li>
 <li>
 Location(s): 9400 Southpark Center Loop, Suite 200, Orlando, Florida 32819
 </li>
 <li>
 Schedule Requirements: Monday through Friday; 10:00pm-7:00pm or 11:00am-8:00pm EST post-training schedule offered depending on availability
 </li>
 <li>
 Remote Opportunity: The opportunity is primarily remote, but may require onsite attendance as needed
 
 
 </li>
 </ul>
 
 About AssistRx:
 
 Voted
 
 Top Work Places in Orlando 3 years in a row
 
 , AssistRx understands that the key to success is our fantastic team members. AssistRx has engineered the perfect blend of technology and talent to deliver best in class results. We believe that access to specialty therapies transforms lives and is achieved through the powerful combination of our people and technology. Want to know more? Follow us on LinkedIn to find out how our team members are
 
 #TransformingLives.
 
 
 
 
 Why Choose AssistRx:
 
 
 
 <ul>
 <li>
 Work Hard, Play Hard: Preloaded PTO: 100 hours (12.5 days) PTO upon employment, increasing to 140 hours (17.5 days) upon anniversary. Tenure vacation bonus: $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary
 </li>
 <li>
 Impactful Work: Join a team that is at the forefront of revolutionizing healthcare by improving patient access to essential medications
 </li>
 <li>
 Flexible Culture: Many associates earn the opportunity to work a hybrid schedule after 120 days after training. Enjoy a flexible and inclusive work culture that values work-life balance and diverse perspectives
 </li>
 <li>
 Career Growth: We prioritize a "promote from within mentality". We invest in our employees' growth and development via our Advance Gold program, offering opportunities to expand skill sets and advance within the organization
 </li>
 <li>
 Innovation: Contribute to the development of groundbreaking solutions that address complex challenges in the healthcare industry
 </li>
 <li>
 Collaborative Environment: Work alongside talented professionals who are dedicated to collaboration, learning, and pushing the boundaries of what's possible. Tell your friends about us! If hired, receive a $750 referral bonus!
 
 
 </li>
 </ul>
 
 A Day in the Life as a Insurance Verification Specialist:
 
 
 
 This role works directly with healthcare providers &amp; insurance plans/payers to gather information about a patient's insurance and the coverage provided for a specific pharmaceutical product. The
 
 Insurance Verification Specialist
 
 will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for
 
 Prior Authorizations
 
 (PA) for an assigned caseload and helps navigate the appeals process to access medications.
 
 
 <ul>
 <li>
 Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures; in a manner that provides the best level of service and quality
 </li>
 <li>
 Conduct benefit investigations for patients by making outbound phone call to payers to verify patient insurance benefit information, navigate complex reimbursement barriers and seek resources to overcome the barriers
 </li>
 <li>
 Verify patient specific benefits and document specifics including coverage, cost share and access/provider options
 </li>
 <li>
 Identify any coverage restrictions and details on how to expedite patient access
 </li>
 <li>
 Document and initiate prior authorization process and claims appeals
 </li>
 <li>
 Report any reimbursement trends or delays in coverage to management
 </li>
 <li>
 Act as a liaison for field representatives, health care providers and patients
 
 
 </li>
 </ul>
 
 Requirements
 
 
 
 
 Qualifications to be a Insurance Verification Specialist:
 
 
 
 <ul>
 <li>
 In-depth understanding and experience with Major Medical &amp; Pharmacy Benefit Coverage
 </li>
 <li>
 2 to 3 years of benefit investigation involving the analysis and interpretation of insurance coverage
 </li>
 <li>
 2 to 3 years of experience interacting with healthcare providers in regard to health insurance plan requirements
 </li>
 <li>
 Excellent verbal communication skills and grammar
 </li>
 <li>
 Salesforce system experience preferred
 
 
 </li>
 </ul>
 
 Benefits
 
 
 
 Want to learn more about what employee benefits AssistRx offers? Here are some additional benefits that our employees enjoy!
 
 
 <ul>
 <li>
 Medical, dental, vision, life, &amp; short-term disability insurance
 </li>
 <li>
 Teledoc services for those enrolled in medical insurance
 </li>
 <li>
 Supportive, progressive, fast-paced environment
 </li>
 <li>
 Competitive pay structure
 </li>
 <li>
 Matching 401(k) with immediate vesting
 </li>
 <li>
 Legal insurance
 
 
 </li>
 </ul>
 Wondering how we recognize our employees for delivering best in class results? Here are some of the awards that our employees receive throughout the year!
 
 
 <ul>
 <li>
 #TransformingLives Honor: This quarterly award program is a peer to peer honor that recognizes and highlights some of the amazing ways that our team members are transforming lives for patients on a daily basis
 </li>
 <li>
 Values Award: This quarterly award program recognizes individuals who exhibit one, or many, of our core company values; Excellence, Winning, Respect, Inspiration, and Teamwork
 </li>
 <li>
 Vision Award: This annual award program recognizes an individual who has gone above and beyond to support the AssistRx vision to transform lives through access to therapy
 
 
 </li>
 </ul>
 AssistRx, Inc. is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors, or any other protected categories protected by federal, state, or local laws.
 
 
 All offers of employment with AssistRx are conditional based on the successful completion of a pre-employment background check.
 
 
 In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position.
 
 
 AssistRx does not accept unsolicited resumes from search firms or any other vendor services. Any unsolicited resumes will be considered property of AssistRx and no fee will be paid in the event of a hire.
</div>

Insurance Verification Specialist - Specialty Pharmacy

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