Insurance Verification Representative

Insurance Verification Specialist

Verifies patient insurance coverage and benefit information. Obtains authorizations from insurance carriers prior to providing care/treatment to patients. Documents referrals, communications, insurance details, and patient data in the electronic medical record (EMR). Gathers information, handles inquiries, and accurately enters codes for insurance billing purposes.

Essential Functions

• Verify insurance companies and primary care physicians (PCP) online or over the phone to obtain benefit information
• Complete billing tasks in a timely manner
• Call primary care physicians to obtain referrals and/or authorizations when required
• Inform patients regarding their insurance benefits, copays, deductibles, and self-pay balance due
• Enter the authorization number in EMR with the correct CPT codes, NPI, Tax ID, PCP, and payer information
• Follow up with the PCP or the insurance company for the authorization requested
• Cancel and reschedule the patient's appointment when the authorization has not arrived prior to the DOS
• Check if the patient's insurance information is correct and matches the insurance verification, and expire all inactive payers
• Answer phones promptly and courteously; handle requests and inquiries, or route accordingly

Requirements

Job Specifications

• Customer Service experience
• Ability to handle multiple tasks simultaneously in a fast-paced environment
• Ability to handle and diffuse patient complaints and disagreements
• Exceptional communication and interpersonal skills
• Experience navigating Electronic Medical Records and Outlook preferred
• Bilingual in English/Spanish
• For roles that are remote (i.e., Work From Home (WFM)) or hybrid (i.e., partial onsite at a VSP location and WFM), must demonstrate a high level of engagement in virtual environments, including maintaining camera presence during meetings to support effective communication and team alignment

Salary Description $15.00 - $17.50