Insurance Verification Specialist

About Blue Water Thinking Guided by our principles of value generation, continuous innovation, customer-centricity, and vested collaboration, Blue Water Thinking proudly supports our Federal clients in achieving their Agency goals. Founded by a decorated twenty-eight year Veteran of the United States Army, Blue Water Thinking understands and supports the mission of our Nation's war fighters, Veterans, their families and caretakers. Leveraging our executive team's military experience and private and public sector consulting expertise, Blue Water Thinking takes an integrated "one-team" approach and brings to bear best-fit solutions, thought leadership, and grit to meet our client's transformational needs. Fueled by our values of integrity, respect, professionalism, stewardship and customer service, the Blue Water Thinking team understands the power of the human connection, collaboration, humility and loyalty to one another, our clients and industry partners. Lastly, our formula for success is simple: Build something good, take care of our people, keep our clients satisfied, nurture our work ethic and reputation, build long-lasting partnerships, enjoy what we do and give back as much as possible. Job Description Blue Water Thinking is seeking an experienced and dedicated Insurance Verification Specialist to join our team, supporting the Department of Veterans Affairs. The primary responsibility of this position is to perform insurance verification and related billing activities, including verifying patient insurance coverage, eligibility, benefits, policy information, and reimbursement requirements to support accurate and timely claims processing for the Veterans Health Administration (VHA). Responsibilities Performs verification of patient insurance coverage through automated databases, direct patient contacts, and communication with insurance companies. Verifies insurance benefits, policy numbers, pre-certification requirements, eligibility, and effective dates of coverage. Accepts and completes work provided through a standardized control system, such as batched work, caseload levels, or other defined workflows. Performs Medicare and commercial insurance reimbursable billing activities. Ensures that all billable cases are accurately identified and that bills are generated correctly and timely. Validates claims for billing purposes, ensuring patient eligibility and referring questionable or potentially inaccurate coding for appropriate review. Reviews insurance and billing information to identify discrepancies, missing information, or issues that may affect reimbursement. Follows established instructions regarding timeliness, objectives, priorities, and workload requirements. Exercises sound judgment to determine the appropriateness and accuracy of data and information provided on claims. Effectively communicates with internal staff and other stakeholders as necessary to resolve billing, insurance, eligibility, and claim discrepancies. Uses a wide range of office software applications and electronic systems to document, process, track, and manage insurance verification and billing activities. Maintains accurate and complete documentation in accordance with applicable VA, VHA, contractual, and organizational requirements. Protects sensitive patient and insurance information and follows applicable privacy, security, and information-handling requirements. Minimum Qualifications High School Diploma or equivalent. Two years of experience in insurance verification, medical billing, healthcare revenue cycle, patient financial services, claims processing, or a related healthcare administrative function. Demonstrated experience verifying insurance eligibility, benefits, coverage dates, policy information, and authorization or pre-certification requirements. Experience working with Medicare and/or commercial health insurance claims and reimbursement processes. Proficiency with Microsoft Office applications, electronic databases, and other office or healthcare information systems. Strong attention to detail with the ability to accurately review claims, insurance information, and billing documentation while meeting established deadlines. Preferred Qualifications Experience supporting the Department of Veterans Affairs, Veterans Health Administration, or other federal healthcare programs. Experience with VHA or VA healthcare administrative, billing, eligibility, or revenue cycle processes. Familiarity with Medicare, commercial insurance, third-party billing, and healthcare reimbursement requirements. Knowledge of medical terminology, insurance terminology, claims processing, and healthcare revenue cycle workflows. Experience working with electronic health records, patient management systems, insurance verification platforms, or medical billing applications. Familiarity with claim validation, coding review processes, eligibility verification, and identifying billable services. Strong written and verbal communication skills with the ability to collaborate effectively with clinical, administrative, billing, and insurance personnel. Ability to manage multiple priorities, meet production and quality requirements, and work effectively within standardized workflows. Experience handling sensitive patient information in accordance with applicable privacy and security requirements. Eligibility Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future Must be able to obtain and maintain the required federal public trust clearance for this role Compensation Salary for this position is determined by various factors, including but not limited to, location, the candidate’s particular combination of knowledge, skills, competencies and experience, as well as contract specific affordability and organizational requirements. The proposed salary range for this position is outlined below. Salary range: $45,000-$60,000 (or $21.60/hr to $28.85/hr). Willing to consider candidates on a part-time basis for highly qualified individuals with substantial VA experience. Benefits Blue Water Thinking offers a comprehensive benefits package including health insurance (medical, dental and vision), paid time off, federal holidays, and matching 401K plan. Reasonable Accommodation for Applicants Blue Water Thinking is committed to providing reasonable accommodations to qualified individuals with disabilities throughout the application and hiring process. If you require a reasonable accommodation to search for a position, complete an application, or participate in the interview process, please contact Resource Management at View email address on click.appcast.io. Requests for accommodation will be handled promptly and confidentially in accordance with applicable law. Our Commitment to Equal Employment Opportunity. Blue Water Thinking is an Equal Opportunity Employer. We recruit, hire, train, and promote qualified individuals without regard to race, color, religion, sex, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law. #J-18808-Ljbffr OpenKrill