Insurance Verification Rep
$20 - $24 per hourPrestige Staffing Healthcare Jobs - Clinical & Allied Health
JobID: 53830 Insurance Verification Job Description: Pay: $20-24/hr Location: Atlanta, GA or Conyers, GA (Onsite) Position Summary The Insurance Verification Specialist is responsible for confirming and documenting insurance coverage and authorization requirements for both physician (professional) and hospital (facility) services . This role requires strong Epic proficiency and at least 2 years of hands-on insurance verification experience , ensuring accurate benefit validation, eligibility checks, and timely communication with payers, patients, and internal clinical/revenue cycle teams. Key Responsibilities
- Verify patient insurance eligibility, benefits, and coverage details for physician and hospital/facility services (e.g., outpatient, inpatient, procedures, imaging, dialysis/infusion where applicable).
- Use Epic to review patient accounts, update insurance information, and document verification outcomes and required follow-ups.
- Confirm key benefit details, including (as applicable):
- Effective dates, plan type, and network status (in/out of network)
- Deductibles, copays, coinsurance, out-of-pocket maximums
- Referral requirements and PCP designation rules
- Coverage limitations, exclusions, and medical necessity rules
- Identify when prior authorizations / pre-certifications are required and coordinate next steps with internal teams and/or payer portals.
- Communicate professionally with:
- Insurance carriers (commercial, Medicare, Medicaid, managed care)
- Patients and families regarding coverage, financial responsibility, and next steps
- Provider offices, hospital departments, and scheduling teams to prevent delays in care
- Ensure all verification data is complete, accurate, and entered timely to support clean billing and reduce denials.
- Support denial prevention by proactively resolving coverage discrepancies before services are rendered.
- 2+ years of insurance verification experience (healthcare setting required).
- Demonstrated experience verifying for both physician/professional and hospital/facility services.
- Epic experience required (eligibility/coverage review and documentation).
- Strong knowledge of payer types and plan structures: HMO/PPO, Medicare, Medicaid , and commercial plans.
- Ability to interpret insurance responses and explain benefits/financial responsibility clearly.
- Strong attention to detail, follow-through, and ability to manage multiple verifications in a fast-paced environment.
- Experience in a specialty practice environment (e.g., nephrology/dialysis) and/or working closely with hospital-based services.
- Familiarity with payer portals and electronic verification tools.
- Prior authorization / pre-cert experience.
Vacancy posted 1 day ago
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