Insurance Verification Specialist

Insurance Verification Specialist is responsible for the pre-verification of insurance for patients being admitted into the hospital for care. Ensures insurance coverage by telephone, resolves any issues with coverage and escalates complicated issues to a supervisor or manager. Being an Insurance Verification Specialist interviews patients and completes all paperwork necessary to ensure the admitting process is efficient and all hospital and regulatory policies are in compliance. May require a bachelor’s degree in area of specialty. Additionally, Insurance Verification Specialist typically reports to a supervisor or manager. To be an Insurance Verification Specialist typically requires 2 to 4 years of related experience. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work.

Insurance Verification Specialist Job Description Template

Our company is looking for a Insurance Verification Specialist to join our team.

Responsibilities:

  • Relay policy benefit information to clients in a comprehensive and professional manner;
  • Coordinate completion of prior authorization, if needed;
  • Receiving, cataloging, and tracking progress of verification requests received;
  • Obtaining referrals and authorizations;
  • Ensures patient satisfaction;
  • Collect co- pays or past balances;
  • Verifies insurance information;
  • Prints dictation letters;
  • Greets patients upon check-in/registration and tracks patients in waiting areas;
  • Reviews fee tickets upon patient check-out; ensures all fees are collected;
  • EMR administration, documentation and scanning;
  • Reviews and verifies information in patient charts;
  • Responsible for verifying patient insurance coverage to ensure necessary visits are covered by the payer;
  • Obtain all necessary authorizations for recommended treatment per payer requirements;
  • Assist in the collection of patient copays/coinsurance.

Requirements:

  • Must uphold a gold standard customer service approach to all client interactions;
  • Must be proficient in basic computer skills relating to data entry, email, Microsoft Word and Excel;
  • Basic knowledge of medical insurance benefits and policies;
  • Must be able to manage workload and complete assignments in a timely manner, whether supervised or not;
  • Must project professionalism and be a team player;
  • Must possess excellent verbal and written communication skills;
  • High school graduate or equivalent degree.