Insurance Verification Specialist

Job Title: Insurance Verification Coordinator Job Description The Insurance Verification Coordinator verifies insurance eligibility and benefits, completes prior authorizations, and supports patients, providers, and payors to ensure accurate coverage and timely access to prescribed therapies. This role combines detailed insurance and benefits investigation with high-volume patient and provider communication, while maintaining excellent documentation and quality standards. Responsibilities Obtain and verify insurance eligibility and benefits for services and medications, and document complete and accurate information in the system. Perform prior authorizations as required by each payor, including gathering and submitting all necessary documentation by collaborating with physician offices and insurance companies. Collect and record relevant clinical information, such as lab values and diagnosis codes, to support coverage and authorization decisions. Determine each patients financial responsibility based on insurance coverage, including copays, coinsurance, and deductibles. Configure and maintain coordination of benefits information on every referral to ensure correct primary and secondary billing. Ensure assignments of benefits are obtained and on file for Medicare claims, in alignment with payor requirements. Communicate with insurance companies regarding therapies provided, including benefit clarification, coverage issues, and claim-related questions. Document all pertinent communication with patients, physicians, and insurance companies, particularly as it relates to reimbursement and collection procedures. Identify and coordinate patient financial assistance resources, including copay cards, third-party assistance programs, and manufacturer assistance programs. Handle inbound calls from patients, physician offices, and insurance companies, providing clear, courteous, and accurate information. Research and resolve claim rejections related to eligibility, coverage, and other insurance issues, escalating as needed. Work from an internal referral queue, processing a high volume of referrals each day while maintaining accuracy and timeliness. Meet or exceed established performance metrics, including daily referral volumes and quality standards. Maintain strong attendance and reliability to support consistent patient and provider service. Essential Skills At least 1 year of medical billing or insurance verification experience, or a bachelors degree in a related field as a substitute for experience. Hands-on experience obtaining insurance benefits directly from health plans and clearly communicating those benefits to patients. Experience submitting prior authorizations directly to payors, including gathering clinical documentation and following up as needed. Knowledge of insurance verification, benefit verification, and coordination of benefits processes. Familiarity with working with various insurance companies and payors, including Medicare and commercial plans. Proficiency with data entry and electronic systems for documenting eligibility, benefits, and communication. Strong customer service skills, with the ability to communicate professionally and empathetically with patients, providers, and insurance representatives. Ability to handle a high volume of referrals while maintaining at least 95% quality or higher. Strong attention to detail and accuracy when reviewing benefits, entering data, and documenting interactions. Ability to troubleshoot and resolve issues related to eligibility, coverage, and claim rejections. Additional Skills & Qualifications High school diploma required; a bachelors degree in a related field is preferred and may substitute for required experience. Experience working with prior authorization processes and appeals is preferred. Experience in healthcare, medical billing, or insurance environments. Ability to interpret explanation of benefits and insurance plan details. Strong organizational skills with the ability to prioritize tasks in a fast-paced setting. Effective verbal and written communication skills when interacting with patients, providers, and payors. Comfort working with clinical information such as diagnosis codes and lab values. Ability to work both independently and as part of a team to meet shared goals and service levels. Work Environment This role operates in a structured, fast-paced healthcare support environment focused on insurance verification for medications, prior authorizations, and appeals. A typical day includes working from an inbound internal queue, handling approximately 25 or more referrals per day, and maintaining a quality standard of 95% or higher. The position involves frequent phone and electronic communication with patients, doctors offices, and insurance plans, as well as extensive use of computer systems for data entry and documentation. Attendance and reliability are critical due to the high volume and time-sensitive nature of referrals. The standard schedule is Monday through Friday, 12:00 p.m. to 9:00 p.m. Eastern Time (11:00 a.m. to 8:00 p.m. Central Time). The work setting supports a professional, detail-oriented culture that emphasizes accuracy, accountability, and excellent customer service. Job Type & Location This is a Contract to Hire position based out of Phoenix, AZ. Pay And Benefits The pay range for this position is $19.00 - $19.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave) Job Type & Location This is a Contract to Hire position based out of Phoenix, AZ. Application Deadline This position is anticipated to close on Nov 17, 2026. Workplace Type This is a fully remote position. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email View email address on click.appcast.io for other accommodation options. San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records. Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools. #J-18808-Ljbffr Actalent