insurance verification specialist

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

Baylor Scott & White Health

<div>
 
 Job Summary
 
 
 
 The Insurance Verification Specialist 1, under general supervision, provides patients, physicians and internal hospital personnel with insurance benefit information. This position ensures timely verification of insurance benefits and financial clearance which has a direct impact to the organization's reimbursement from payers for patient accounts that are scheduled and unscheduled.
 
 
 
 Essential Functions Of The Role
 
 
 
 Performs financial clearance of patient accounts by verifying insurance eligibility and benefits and ensuring all notifications and authorizations are completed within the required timeframe.
 
 
 Completes appropriate payor forms related to notification and authorization.
 
 
 Coordinates the submission of clinical documentation from physicians to payers for authorization needs.
 
 
 Calculates accurate patient financial responsibility.
 
 
 Communicates timely with Utilization Review, and collaborates effectively with physician and facility staff to ensure financial clearance of the patients account prior to scheduled or unscheduled service during the patient&rsquo;s hospital stay.
 
 
 Interprets complex payer coverage information including, but not limited to, network participation status with provider, limited plan coverage and inactive benefits.
 
 
 Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.
 
 
 
 KEY SUCCESS FACTORS
 
 
 
 
 1 Year Of Healthcare Or Customer Service Experience Preferred.
 
 
 
 Must have the ability to consistently meet performance standards of production, accuracy, completeness and quality.
 
 
 Ability to understand and adhere to payer guidelines by plan and service type.
 
 
 Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
 
 
 Ability to maintain a professional demeanor in a highly stressful and emotional environment, behavioral health and/or suffering patients in addition to life or death situations.
 
 
 Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skills.
 
 
 Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
 
 
 Excellent data entry, numeric, typing and computer navigational skills. Basic computer skills and Microsoft Office.
 
 
 
 Benefits
 
 
 
 Our competitive benefits package includes the following
 
 
 <ul>
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 Immediate eligibility for health and welfare benefits
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 401(k) savings plan with dollar-for-dollar match up to 5%
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 Tuition Reimbursement
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 PTO accrual beginning Day 1
 
 
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 </ul>
 Note: Benefits may vary based upon position type and/or level
 
 
 
 Qualifications
 
 
 
 <ul>
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 EDUCATION - H.S. Diploma/GED Equivalent
 </li>
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 EXPERIENCE - Less than 1 Year of Experience
 </li>
 </ul>
</div>

Insurance Verification Specialist (Remote)

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

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>
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 Compensation: $19-22/hr
 </li>
 <li>
 Location(s): 9400 Southpark Center Loop, Suite 200, Orlando, Florida 32819
 </li>
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 Schedule Requirements: Monday through Friday; 10:00pm-7:00pm or 11:00am-8:00pm EST post-training schedule offered depending on availability
 </li>
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 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>
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 Impactful Work: Join a team that is at the forefront of revolutionizing healthcare by improving patient access to essential medications
 </li>
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 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>
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 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>
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 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>
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 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
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 <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>
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 Medical, dental, vision, life, &amp; short-term disability insurance
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 Teledoc services for those enrolled in medical insurance
 </li>
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 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

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

Psychiatry of Texas

About PsychPlus:The current delivery model for mental health care in the United States is broken&mdash;and PsychPlus is on a mission to fix it.PsychPlus is reimagining how mental health care is delivered to every American through a digital-first, modern approach to psychiatry and therapy. We provide care both in-person at our offices across Texas and virtually, allowing patients to receive care when and where it&rsquo;s most convenient.By combining exceptional clinical care with best-in-class technology, we deliver an integrated, patient-centered mental healthcare experience. Join us as we work toward ensuring that every person has access to affordable, accessible, and high-quality mental health care.About the Role:We are seeking a detail-oriented Insurance Verification / VOB Specialist with 1+ year of experience in US Mental/Behavioral health Insurance Verification. The ideal candidate will be responsible for verifying patient insurance coverage and benefits to ensure accurate billing and a seamless patient experience.Key Responsibilities:<ul><li>Perform insurance verification and eligibility checks for patient services</li><li>Review and confirm benefits, coverage, copays, deductibles, and authorization requirements</li><li>Communicate with insurance providers and internal teams to resolve coverage issues</li><li>Maintain accurate documentation in billing or EMR systems</li></ul>Requirements:<ul><li>Intermediate/A-Levels or Bachelor&rsquo;s degree in Healthcare Administration, Finance, or a related field (preferred)</li><li>1 year of hands-on experience in U.S. Mental/Behavioural Health Insurance Verification</li><li>Ability to work on rotational shifts including weekends.</li><li>Strong knowledge of the full RCM lifecycle for mental health and behavioral health services</li><li>Proficiency with EMRs and billing platforms (e.g., CMD or similar systems)</li><li>In-depth understanding of psychiatry billing codes, modifiers, and payer-specific insurance protocols</li><li>Excellent verbal and written communication skills in English</li><li>Proficiency in MS Excel, Google Sheets, and reporting tools</li></ul>Why Join PsychPlus?If you&rsquo;ve made it this far, we&rsquo;re excited to meet you.PsychPlus is a meritocratic, performance-driven startup that moves fast and values ownership and accountability. You may be required to wear multiple hats, adapt quickly, and consistently deliver results. In return, your scope of responsibility and opportunity to make an impact are uncapped.When you succeed at PsychPlus, our patients succeed&mdash;and together we move one step closer to solving the mental health crisis. We hope this role gives you both career-defining experience and the fulfillment that comes from meaningful work.Equal Opportunity EmployerPsychPlus is proud to be an Equal Opportunity Employer. We are committed to fostering an inclusive environment where every team member feels supported and empowered to be their authentic self. All applicants are evaluated solely on their qualifications, without regard to disability or need for accommodation.Pay: Rs50,000.00 - Rs120,000.00 per monthApplication Question(s):<ul><li>How many years of US Medical Billing experience do you have?</li><li>Do you have experience with Mental Health specialty? Please specify all specialties you have worked with.</li><li>Have you used CMD/CollaborateMD?</li><li>Are you willing to work rotational shifts Morning (9AM to 6PM), Afternoon (3PM to 12AM) and Night Shift (7PM to 4AM)?</li><li>Do you have good internet and equipment to work remotely?</li><li>What is your expected salary?</li><li>How soon can you join us?</li></ul>Work Location: Remote

Insurance Verification/VOB Specialist (CollaborateMD Required)

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

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