Insurance Verification Specialist - Hybrid

Job Summary The Insurance Verification Specialist 1, under general supervision, provides insurance benefit information to patients, physicians, and hospital staff. This position ensures timely insurance verification and financial clearance, directly impacting the organization’s reimbursement from payers for both scheduled and unscheduled patient accounts. Benefits Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Essential Functions of the Role Perform financial clearance of patient accounts by verifying insurance eligibility and benefits; ensure all notifications and authorizations are completed within the required timeframe. Complete appropriate payer forms related to notification and authorization. Coordinate the submission of clinical documentation from physicians to payers for authorization needs. Calculate accurate patient financial responsibility. Communicate timely with Utilization Review and collaborate effectively with physician and facility staff; ensure financial clearance of the patient’s account before any service during the hospital stay. Interpret complex payer coverage information, including network participation status, limited plan coverage, and inactive benefits. Document systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement. Key Success Factors 1 year of healthcare or customer service experience preferred. Ability to consistently meet performance standards of production, accuracy, completeness, and quality. Ability to know and adhere to payer guidelines by plan and service type. Good listening and communication skills, and professional telephone etiquette. Maintain a professional demeanor in stressful, emotional environments with behavioral health or suffering patients, and in life or death situations. Show high empathy and communicate well with patients and families during trauma; demonstrate exceptional customer service skills. Ability to manage multiple, changing priorities in an effective and organized manner. Excellent data entry, numeric, typing, and computer navigational skills. Basic computer skills and Microsoft Office. Belonging Statement We believe that all people should feel welcomed, valued and supported. Qualifications Education: H.S. Diploma/GED Equivalent Experience: Less than 1 Year of Experience #J-18808-Ljbffr NACBA