Insurance Verification Specialist

About the role

The Insurance Verification Specialist is a frontline collector-level position responsible for verifying patient insurance coverage, benefits, and eligibility prior to service delivery. This role is critical to minimizing claim denials, reducing revenue leakage, and improving patient financial experience.

What you'll do

• Verify patient insurance eligibility and benefits using online portals (Availity, Emdeon, payer-specific portals) and phone verification
• Extract, document, and maintain accurate insurance information (policy numbers, group numbers, effective dates, deductibles, copays, out-of-pocket maximums)
• Identify and flag eligibility gaps, excluded services, and prior authorization requirements
• Research claim denials related to insurance eligibility and submit appeals with supporting documentation
• Follow up on claim status with insurance carriers and resolve payment discrepancies

What you need

• 1–2 yrs of experience
• Insurance
• Excel
• Reporting
• Reconciliation
• Collections
• Clinical data management
• Diploma

Good to have

• SOP writing