Insurance Verification Specialist
Job Description
Key Responsibilities
Verify insurance eligibility, coverage, and benefits prior to patient appointments.
Confirm out-of-network benefits, deductibles, coinsurance, and out-of-pocket maximums.
Identify authorization, referral, and other insurance requirements.
Review upcoming appointments to ensure patient demographics, insurance information, and required documentation are complete.
Identify coverage discrepancies and communicate outstanding items to the appropriate teams.
Accurately document verification findings in the EMR and applicable tracking systems.
Assist with pre-visit financial readiness and front-desk coordination.
Requirements
Qualifications
Previous experience in medical insurance verification and eligibility.
Strong knowledge of out-of-network insurance benefits and reimbursement structures.
Understanding of commercial insurance plans, deductibles, coinsurance, and authorization requirements.
Experience navigating insurance payer portals and contacting insurance carriers.
Familiarity with medical billing terminology and revenue cycle processes.
Experience with eClinicalWorks (eCW) preferred.
Strong attention to detail, communication skills, and ability to manage a high volume of patient verification
Benefits
- International work environment
- Professional development opportunities
- Career growth based on performance
- Continuous learning culture
- Collaborative teams
- Future internal mobility opportunities
Requirements
Industry Experience: Minimum 6m - 2 years of experience focusing specifically on out-of-network (OON) commercial insurance claims follow-up. Communication Skills: Excellent verbal communication skills with a proven track record of handling high-volume professional phone outreach to insurance payers. Technical Proficiency: Hands-on experience navigating Electronic Medical Record (EMR) systems and working with shared spreadsheets (Excel/Google/Zoho Sheets). Efficiency: Proven ability to meet strict daily performance, quality, and productivity metrics. Attention to Detail: Sharp organizational skills required for capturing claim reference numbers and assembling medical record packages accurately.