verification specialist

Heart Care Centers of Illinois

Heart Care Centers of Illinois, a multi-site network of cardiovascular providers, currently has an opening for an Insurance Verification Specialist responsible for providing guidance, instruction, and assistance to the managed care team and front desk staff. The ideal candidate will possess a strong understanding of managed care, medical office procedures, and insurance verification processes. In this role, you will be responsible for verifying patient insurance coverage, ensuring compliance with HIPAA regulations, and facilitating smooth billing operations. Your expertise in medical terminology, coding systems, and insurance protocols will be vital in supporting accurate patient account management and optimizing revenue cycle processes.Major Duties and Responsibilities:<ul><li>Process and prioritize insurance verifications, referrals, and prior authorization requests. Refers authorization requests that require clinical judgment to Prior Authorization Supervisor.</li><li>Verifies member/patient eligibility, entering information in IDX system. Ensures insurance carrier documentation requirements are met and referral support documentation is filed in patient records.</li><li>Trains new and existing front desk staff on managed care procedures and protocols.</li><li>Identifies and informs callers of network providers, services, and available member benefits. Informs providers of patient service decisions. Support prior authorizations and referral clinicians.</li><li>Coordinates with members, providers and key departments to promote an understanding of Prior Authorization, Referral, and Insurance Verification requirements and processes.</li><li>Maintains and updates general understanding of application sections of evidence of coverage, handbooks, etc. Assists other Managed Care Specialists with questions and concerns.</li></ul>Requirements<ul><li>Minimum of 1 year experience with Health Plan Utilization/Insurance Claims, knowledge of third party payor regulations, compliance policies, medical terminology and coding</li><li>Strong knowledge of managed care plans, HIPAA regulations, and healthcare compliance standards.</li><li>Excellent communication skills for interacting effectively with patients, providers, and insurance representatives.</li></ul>Heart Care Centers of Illinois offers a competitive salary with great benefits and a weekday only/no evenings schedule. Apply today!Pay: From $23.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Disability insurance</li><li>Employee assistance program</li><li>Employee discount</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Parental leave</li><li>Referral program</li><li>Retirement plan</li><li>Vision insurance</li><li>Wellness program</li></ul>Work Location: In person

Insurance Verification Specialist

Spring Creek Urology Specialists

Extremely busy Urology office seeks experienced insurance verification specialist. Must have recent medical office insurance verification experience. Must be able to multi-task and pay attention to detail to. Verify insurance for 100+ patients per day. Verify for surgical procedures and call patients to collect surgery amounts prior to surgery. Must be familiar with insurance terminology including copays, deductibles, and coinsurance amounts and how they apply. E-clinical works EMR experience helpful. Must be able to work in fast paced environment and be able to complete all daily work tasks prior to leaving for the day. Will be required to cover other personnel in the department as needed which will increase work load.Must be able to start immediatelyUnfortunately, due to the volume of the office and tasks, we are unable to train applicants with no insurance verification experience.Job Type: Full-timePay: $18.00 - $20.00 per hourBenefits:<ul><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Experience:<ul><li>Recent Medical office setting: 1 year (Required)</li><li>Medical office setting Insurance verification: 2 years (Required)</li></ul>Work Location: In person

Emory Healthcare

<div>Overview:

Be inspired. Be valued. Belong. At Emory Healthcare
At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:<ul><li>
 Comprehensive health benefits that start day 1</li><li>
Student Loan Repayment Assistance &amp; Reimbursement Programs</li><li>
Family-focused benefits</li><li>
Wellness incentives</li><li>
Ongoing mentorship, development, leadership programs</li><li>
And more</li></ul>
Description:
<div>
RESPONSIBILITIES:</div> 
<div></div><ul><li>
Under general supervision, coordinates activities related to credentialing of Medical Staff and Allied Health professionals.</li><li>
Maintains current copy of Medical Staff Bylaws, Rules and Regulations. Prepares monthly schedule of medical staff and departmental meetings. Prepare agendas, attends, transcribes and maintains minutes for medical staff meetings.</li><li>
Enters arid retrieves data from computer using CAS/EHIS database management software.</li><li>
Makes requests of and reports to the National Data Bank as required. Coordinates the credentialing process for appointments/reappointments in compliance with the hospital Bylaws.</li><li>
Coordinates with Q.A. Coordinates all preparation activity for J.C.A.H.O. surveys regarding Medical Staff and/or Credentialing area. Performs related responsibilities as required.</li></ul><div></div><div> 
MINIMUM QUALIFICATIONS:</div> 
<div></div><ul><li>
A high school diploma or equivalent and one year of credentialing experience in an acute care hospital, managed care organization and/or credentialing verification organization.</li><li>
A bachelor's degree may be substituted in lieu of experience.</li><li>
A basic knowledge of accreditation standards and state and federal credentialing related regulations and a working knowledge of medical terminology are preferred.</li><li>
Must have experience with word processing and database management computer applications.</li></ul>
Additional Details:
<div>
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.</div><div></div><div> 
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare&rsquo;s Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.</div></div>

Credentialing Verification Specialist

AssistRx

<div>AssistRx has engineered the perfect blend of technology and talent to deliver best in class results. We believe that access to therapy transforms lives and is achieved through the powerful combination of our people and technology. We leverage advanced custom software, data analytics, and a patient-centered approach to transform medication management into a seamless and efficient process.
***VOTED one of Orlando's BEST PLACES TO WORK two years in a row***
****WORK FROM HOME AVAILABLE AFTER 120 DAYS**** 
Job Details Snapshot<ul>
<li>Compensation: $19-$22/hr
</li><li>Location(s): 4500 W 107th St, Overland Park, KS 66207
</li><li>Work from home: The opportunity to work from home will be made available after 120 days upon goals and quotas being met at the discretion of the manager.</li>
<li>Visit our Website: https://www.assistrx.com/
</li></ul>Why Choose AssistRx:<ul>
<li>Competitive Compensation: 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 from home after 120 days. Enjoy a flexible and inclusive work culture that values work-life balance and diverse perspectives.</li>
<li>Career Growth: We prioritize a &ldquo;promote from within mentality&rdquo;. 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> 
 
Requirements 
What You Need to Be Successful:<ul>
<li>1-2 years of experience communicating with healthcare professionals and field support staff</li>
<li>3 to 5 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>
<li>Preferable: experience with buy &amp; bill insurance process</li>
<li>Gathers patient data, addresses the needs of the patient and reviews insurance benefits.
</li><li>Records the call details in patient data system.
</li><li>Contacts insurers for verification of benefits.</li>
<li>Conducts follow-up with pharmacies.</li> 
</ul> 
 
Benefits 
<ul>
<li>Supportive, progressive, fast-paced environment</li>
<li>Competitive pay structure</li>
<li>Matching 401(k) with immediate vesting</li>
<li>Medical, dental, vision, life, &amp; short-term disability insurance</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>

Provider Business Partners

Medical billing company seeking an Experienced Insurance Verification Specialist.Ideal candidate will have knowledge and experience with insurance verification of benefits, obtaining referrals and authorizations through payors, as well as excellent typing and 10-key skills. This position can be remote.This position requires heavy phone usage and the ability to sit for extended periods of time.Position is a full-time position. This position is remote.**The ability to provide your own equipment is a plus**Company offers flexible working hours, paid time off, paid holidays, health benefits, life insurance, vision, and dental, AFLAC, and a comfortable working environment.Qualified candidates should reply to this ad with resume and salary requirements.Job Type: Full-timePay: Up to $15.00 per hourBenefits:<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>Medical billing: 1 year (Preferred)</li><li>Insurance verification: 1 year (Required)</li></ul>Work Location: Remote

Medical Insurance Verification Specialist

Agay Barho!

<div>
 Our client Dial Pro Solutions is looking for a Call Center Verification Specialist in Rawalpindi.
 
 
 Dial Pro Solutions is seeking dedicated Call Centre Verifiers to join our team. The ideal candidate plays a crucial role in ensuring accurate customer verification, managing client relationships, and effectively promoting our products and services to business clients. This position requires a fluent English speaker with strong communication and multitasking skills, capable of building trust and maintaining a professional diary for client interactions. Verifiers will utilize identity verification software and precise data entry techniques to uphold the integrity of our verification procedures while supporting business-to-business selling activities. In this role, Call Centre Verifiers are responsible for delivering exceptional customer service by understanding client needs and providing accurate product knowledge. Candidates should have at least one year of experience in a related role and be proficient in research and problem-solving to address various customer inquiries. Although this position does not involve managing a team, it demands a proactive approach to managing workload, promoting services, and maintaining high standards of data accuracy and communication.
 
 
 
 Responsibilities
 
 
 
 <ul>
 <li>
 Conduct thorough customer verification using established procedures and identity verification software to ensure compliance and accuracy.
 </li>
 <li>
 Perform precise data entry to maintain up-to-date and accurate customer records in systems.
 </li>
 <li>
 Communicate clearly and effectively with clients to build relationships, establish trust, and provide excellent service.
 </li>
 <li>
 Manage client diaries efficiently to schedule appointments and follow up on client interactions.
 </li>
 <li>
 Promote Dial Pro Solutions' products and services to business clients, focusing on business-to-business selling strategies.
 </li>
 <li>
 Apply sales skills to identify client needs, provide suitable product recommendations, and close sales.
 </li>
 <li>
 Research client information and market trends to tailor communication and sales approaches effectively.
 </li>
 <li>
 Handle multiple tasks simultaneously while maintaining composure and ensuring high accuracy in all interactions.
 </li>
 <li>
 Resolve customer issues and inquiries promptly by using problem-solving expertise to enhance client satisfaction.
 </li>
 <li>
 Maintain up-to-date knowledge of products and services to deliver precise and accurate information to clients.
 </li>
 </ul>
</div>

Call Center Verification Specialist - TJ / 1825574

Whole Mind

Join a Mission-Driven Mental Health TeamWhole Mind is a growing outpatient psychiatric practice committed to delivering high-quality, evidence-based mental health care. We provide medication management and advanced interventional treatments including Spravato (esketamine) and Transcranial Magnetic Stimulation (TMS).We are seeking a detail-oriented and proactive Benefits Investigation &amp; Insurance Verification Specialist to join our Pleasant Grove team. This role is critical to ensuring patients understand their coverage, financial responsibility, and eligibility before receiving care &mdash; directly supporting both patient experience and organizational sustainability.If you thrive in a structured environment, enjoy working behind the scenes to solve insurance puzzles, and take pride in accuracy and follow-through, we would love to meet you.What You&rsquo;ll Do<ul><li>Verify insurance eligibility and benefits prior to patient appointments</li><li>Conduct detailed benefits investigations for commercial, Medicaid, Medicare, and managed care plans</li><li>Confirm in-network status and authorization requirements</li><li>Determine patient responsibility (deductibles, co-insurance, co-pays, out-of-pocket maximums)</li><li>Document benefits clearly and accurately in AdvancedMD (EMR)</li><li>Communicate financial responsibility to patients, front desk, and billing teams</li><li>Identify and escalate discrepancies or payer issues</li><li>Assist with prior authorization preparation when needed</li><li>Maintain strict HIPAA compliance and patient confidentiality</li></ul>What We&rsquo;re Looking For<ul><li>1&ndash;3 years of insurance verification or healthcare billing experience preferred</li><li>Experience verifying benefits for behavioral health or specialty treatments strongly preferred</li><li>Familiarity with commercial payers, Medicaid, and Medicare</li><li>Strong understanding of deductibles, co-insurance, and authorization requirements</li><li>High attention to detail and strong organizational skills</li><li>Ability to manage multiple payer portals and phone calls efficiently</li><li>Clear, professional communication skills</li><li>Comfortable working in a fast-paced, structured, in-office environment</li></ul>Why This Role MattersAccurate insurance verification:<ul><li>Reduces claim denials</li><li>Improves cash flow</li><li>Prevents patient billing surprises</li><li>Protects the clinic from compliance risk</li><li>Enhances patient trust</li></ul>This is a foundational operational role within the clinic.What We Offer<ul><li>Health, Dental, &amp; Vision Insurance</li><li>401(k) with employer match</li><li>Paid Time Off</li><li>Paid Holidays</li><li>Supportive and collaborative team environment</li><li>Opportunity to grow within a multi-location mental health organization</li></ul>Pay: $17.00 - $23.00 per hourBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: In person

Benefits Investigation & Insurance Verification Specialist

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Medical Insurance Verification Specialist

Call Center Verification Specialist - TJ / 1825574

Benefits Investigation & Insurance Verification Specialist