Health Insurance Verification Specialist

A Health Insurance Verification Specialist is crucial in the healthcare billing process. They are responsible for verifying patient insurance coverage, processing claims, and ensuring that healthcare services provided by the company are paid timely. 

This role is key to maintaining the financial health of healthcare providers and ensuring that patients receive clear communication about their insurance benefits and obligations.

Health Insurance Verification Specialists handle critical tasks such as verifying patient eligibility for services, obtaining necessary pre-authorizations, processing insurance claims accurately, and resolving discrepancies with insurance companies. 

They update patient records with billing details, assist patients in understanding their insurance coverage, and collaborate with billing departments to ensure efficient payment tracking and issue resolution.

Are you detail-oriented, skilled in communication, and passionate about improving healthcare administrative processes?

Take part in our organization as a Health Insurance Verification Specialist and contribute to our mission of providing efficient healthcare services! 

This is an excellent opportunity to leverage your expertise in insurance verification to ensure that our billing operations run smoothly and our patients are well-informed about their insurance benefits.

Apply now!

• Verify patient insurance coverage and eligibility for services.
• Obtain pre-authorizations and referrals as required by insurance providers.
• Process and submit insurance claims accurately and promptly.
• Communicate with insurance companies to resolve claim denials or discrepancies.
• Update patient records with insurance information and billing details.
• Assist patients in understanding their insurance coverage and financial responsibilities.
• Collaborate with the billing department to track payments and resolve any insurance-related issues.
• Maintain confidentiality of patient information and adhere to HIPAA guidelines.
• Provide excellent customer service to patients regarding insurance inquiries.
• Identify opportunities for process improvements in insurance verification procedures.
• Work closely with healthcare providers to ensure accurate billing and claims processing.
• Handle any insurance-related queries from internal and external stakeholders.
• Prepare reports on insurance verification activities and outcomes for management review.
• Stay updated on changes in insurance regulations and policies.

• Achieve a 95% accuracy rate in insurance verification and claims processing.
• Decrease claim denials by 15% through improved verification processes.
• Process a minimum of 50 insurance claims per week with minimal errors.
• Reduce outstanding insurance claim amounts by 20% within the first six months.
• Improve reimbursement rates from insurance companies by 10% through diligent follow-up.
• Increase patient satisfaction scores related to insurance processes by 20%.

• Bachelor's degree in Healthcare Administration or related field.
• 3-5 years of experience working in health insurance or related roles.
• Familiarity with HIPAA regulations and patient privacy laws.
• Certification in Healthcare Insurance Management or a related field is a plus.
• Strong knowledge of medical terminology, insurance processes, and billing procedures.
• Proficiency in using insurance verification software and tools.
• Analytical thinking ability to interpret insurance policies and claims.
• Excellent attention to detail and accuracy in data entry.
• Problem-solving skills to address insurance-related issues efficiently.
• Effective communication skills to interact with insurance companies and patients.
• Ability to work both independently and collaboratively in a team environment.