Insurance Verification Specialist

Job Description

Job Description

Position Title: Insurance Verification Specialist

Orthopedics New England | Natick, MA

Orthopedics New England is a well-established medical practice with offices in Natick, Newton, and Hopkinton. Our team consists of 13 physicians, 6 physician assistants, and more than 80 staff members who are committed to providing excellent patient care in a professional, fast-paced, and supportive environment.

Our workplace offers:

• A modern office setting
• Casual business attire
• A friendly, relaxed atmosphere
• A lively, team-oriented work environment

Position Summary
The Insurance Verification Specialist is responsible for verifying patients’ insurance coverage and benefits prior to scheduled appointments and procedures. This position works closely with patients, insurance companies, providers, and medical office staff to ensure accurate insurance information and help prevent billing and payment issues.

Essential Duties and Responsibilities

• Experience in verifying patient insurance eligibility and coverage prior to appointments.
• Experience in confirming active coverage, benefits, deductibles, copayments, coinsurance, and out-of-pocket requirements.
• Determine whether referrals, authorizations, or precertifications are required.
• Contact insurance companies by phone or through online insurance portals to obtain benefit information.
• Accurately document insurance verification results in the electronic medical record (EMR) and/or practice management system.
• Identify and resolve discrepancies in patient demographic and insurance information.
• Communicate insurance requirements and estimated patient financial responsibility to patients in a clear and professional manner.
• Coordinate with front-desk, clinical, authorization, and billing staff regarding insurance-related issues.
• Follow up on missing, incorrect, or expired insurance information.
• Maintain patient confidentiality and comply with HIPAA and applicable healthcare regulations.
• Perform other administrative duties as assigned.

Position Details

• Job Type: Full-time
• Hours: fulltime 40hours
• Location: Natick, MA
• Pay Range:  $25.00-$26.00 per hour

Benefits

• 401(k) participation
• 401(k) matching and profit-sharing opportunities
• Paid time off
• Individual Health Plan

Orthopedics New England is dedicated to excellence in the evaluation and treatment of injuries and conditions of the bones, joints, muscles, nerves, and tendons. Since 1975, patients from across Massachusetts, and throughout the United States, have placed their trust in our care—state-of-the-art orthopedic care. Our highly skilled, board-certified orthopedic physicians provide a comprehensive range of care covering virtually every orthopedic specialty, where they combine expertise with compassion to restore your function and safely return you to health. Our physicians are patent-holders, authors, university professors, clinic instructors, fellowship-trained, and proud orthopedic team physicians to several professional, college, and high school athletic teams.

Company Description

Orthopedics New England is dedicated to excellence in the evaluation and treatment of injuries and conditions of the bones, joints, muscles, nerves, and tendons. Since 1975, patients from across Massachusetts, and throughout the United States, have placed their trust in our care—state-of-the-art orthopedic care. Our highly skilled, board-certified orthopedic physicians provide a comprehensive range of care covering virtually every orthopedic specialty, where they combine expertise with compassion to restore your function and safely return you to health. Our physicians are patent-holders, authors, university professors, clinic instructors, fellowship-trained, and proud orthopedic team physicians to several professional, college, and high school athletic teams.