Insurance Verification Specialist

Job Purpose: Provides support to the medical office between the Credentialing, Front Desk, and Call Center Departments as needed. Serves staff and patients by helping them in a professional and courteous manner.

Job Duties:

• Anticipate patients' concerns, answer questions, and maintain an organized office area at all times.


• Protect patients' rights by maintaining confidentiality of personal and financial information.


• Maintain accurate patient records by obtaining, recording, and updating patient information.


• Obtain revenue by charging and collecting payments from patients, then recording and posting financial information to patient charts.


• Maintain operations by following office policies and procedures.


• Contribute to department effort and assist in additional tasks, as needed.


• Answer daily telephone calls in a professional manner/make daily phone calls if needed.


• Perform other related duties as assigned by the immediate supervisor or their designee.


• Reports to the Billing or Office Manager


• Confirm patient insurance benefits and account balances


• Respond to insurance inquiries from internal departments, patients, or insurance companies.


• Follow processes or procedures.


• Responsible for the pre-verification of insurance benefits for patients. The insurance verification process includes copays, deductibles, OOP, policy status, referral requirements, pre-existing clause, plan exclusions, authorizations.


• Ensures insurance coverage by telephone or web portal, resolves any issues with coverage, and escalates complicated issues to a supervisor or manager. Follows up on accounts that require further evaluation.

Skills/Qualifications: Multi-tasking, Flexibility, Telephone Skills, Customer Service, Time Management, Organization, Attention to Detail, Scheduling, Word Processing, Professionalism, Quality Focus. Must have a High School diploma and at least 4 years of experience in clerical/administrative duties in a medical office setting. Prolong Sitting.