POSITION SUMMARY

The Insurance Verification Specialist verifies insurance coverage and eligibility for new patients and referrals, and updates coverage information for existing patients. This role obtains pre-authorization for services, requiring strong phone communication skills, and helps patients understand their financial responsibility after coverage has been verified. The Insurance Verification Specialist maintains extensive knowledge of out-of-network insurance benefits and applies medical billing experience to support accurate, compliant patient financial discussions.

ESSENTIAL DUTIES & RESPONSIBILITIES

• Verify insurance coverage and eligibility for patients

• Review and interpret insurance policies and benefits

• Obtain necessary authorizations for medical procedures

• Communicate with insurance companies to resolve any coverage issues or discrepancies

• Update patient records with accurate insurance information

• Assist patients in understanding their insurance coverage and benefits

• Collaborate with the medical billing team to ensure accurate claims submission

• Additional duties as assigned

 COMPENSATION & BENEFITS Pay Range: $25 $29/hr  

 HOURS 10 am- 6pm  EST 

 Benefits Offering:

• Medical
• Dental
• Vision
• Life Insurance
• 401(k)
• Paid Time Off
• Paid Holidays

See PRM full benefits guide with job offer package 

REQUIRED QUALIFICATIONS

• Previous experience in insurance verification or a related field

• Knowledge of medical terminology and coding (ICD-10)

• Familiarity with HIPAA regulations and guidelines

• Proficient in using office software and electronic medical record systems

PREFERRED QUALIFICATIONS

• Prior experience working in a medical office

KNOWLEDGE, SKILLS & ABILITIES

• Extensive knowledge of out-of-network insurance benefits

• Strong phone communication skills

• Strong attention to detail and accuracy in data entry

• Excellent communication skills, both written and verbal

• Ability to work independently and as part of a team in a fast-paced environment

PHYSICAL DEMANDS & WORK ENVIRONMENT

This role involves prolonged periods of computer and phone use in an office-based or hybrid setting, with regular use of electronic medical record systems and office software to verify coverage, process authorizations, and document patient insurance information.