Insurance Verification Rep

Insurance Verification Rep

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.

As an Insurance Verification Representative, you will provide critical pre-service support and meticulous verification of patient insurance benefits, ensuring financial clarity and a smooth patient experience. Every day you will expertly contact insurance payers, confirm coverage details, identify patient responsibilities, and meticulously document all findings to facilitate accurate billing and address potential financial barriers to care. To be successful, you will demonstrate outstanding attention to detail, strong communication skills, and a persistent, customer-focused demeanor, contributing significantly to revenue integrity and informed patient access.

As an Insurance Verification Representative, you will:

• Apply a thorough understanding/interpretation of Verification of Benefits (VOB) to confirm patient eligibility
• Communicate effectively over the phone and through written correspondence with providers, clinical staff, clinic managers, and payers to obtain VOB, and behavioral authorizations.
• Apply understanding and knowledge of medical terminology, payer guidelines, CPT codes, ICD-10 codes to ensure appropriate behavioral authorizations are obtained
• Recognize when additional assistance is needed to resolve complex issues and escalate appropriately and timely through defined communication and escalation channels.
• Resolve work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides.
• Works the claim edit work queues timely and efficiently to correctly resolve the error.

CommonSpirit Health is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF] .