Insurance Verification Specialist

Verify patient insurance eligibility, benefits, and coverage prior to scheduled services. Review and interpret insurance plans, including out-of-network benefits, deductibles, coinsurance, copays, and out-of-pocket responsibilities. Obtain prior authorizations and pre-certifications as required by insurance carriers. Contact insurance companies to resolve eligibility, coverage, and authorization issues. Accurately document and update patient insurance information within the electronic medical record (EMR) system. Educate patients regarding their insurance benefits and anticipated financial responsibility. Collaborate with providers, scheduling staff, and the medical billing team to ensure accurate and timely claims processing. Maintain compliance with HIPAA regulations and company policies regarding patient confidentiality. Perform additional duties as assigned to support departmental and organizational objectives. Requirements Minimum of 2 years of insurance verification, medical billing, or related healthcare experience. Strong knowledge of commercial insurance plans, with extensive experience verifying out-of-network benefits. Experience obtaining prior authorizations and working directly with insurance carriers. Working knowledge of medical terminology and ICD-10 coding. Experience using electronic medical record (EMR) systems and Microsoft Office applications. Exceptional attention to detail and accuracy. Strong verbal and written communication skills. Excellent organizational and time-management abilities. Ability to work independently while also collaborating effectively within a team. Previous experience in a physician practice or medical office is preferred. Core Competencies Demonstrates expertise in verifying patient insurance eligibility and benefits, obtaining prior authorizations, and maintaining compliance with HIPAA regulations. Proficient in using electronic medical record (EMR) systems and possesses strong communication and organizational skills. Highest-signal resume keywords Insurance Verification Prior Authorization Electronic Medical Record (EMR) Systems Medical Terminology Attention to Detail ATS Optimization Keywords Hard Skills Insurance Eligibility Verification Out-of-Network Benefits ICD-10 Coding Medical Billing Claims Processing Soft Skills Verbal Communication Written Communication Organizational Skills Time Management Team Collaboration Industry Keywords HIPAA Compliance Patient Confidentiality Healthcare Experience Insurance Carriers Physician Practice Tools & Technologies Electronic Medical Record (EMR) Systems Microsoft Office Applications #J-18808-Ljbffr