{"@context":"https://schema.org","@type":"JobPosting","directApply":"https://schema.org/False","title":"Medical Insurance Verifications Specialist","description":"Medical Insurance Verification Specialist

Remote Position (Overseas)

Company Overview

We are a growing medical software company based in Tampa/Clearwater, Florida, pushing to become the ecommerce platform of the medical industry. Our innovative solutions streamline healthcare operations while enhancing patient care and provider efficiency. We are seeking detail-oriented and efficient Medical Insurance Verification Specialists to join our remote team and support our insurance verification operations.

Position Summary

The Medical Insurance Verification Specialist will be responsible for verifying patient insurance coverage, eligibility, and benefits prior to medical services being rendered. This fully remote position will involve working with our proprietary software systems to ensure accurate insurance information is collected and verified, reducing claim denials and improving the revenue cycle. The ideal candidate will have strong attention to detail, excellent communication skills, and the ability to work independently in a remote environment.

Key Responsibilities

Insurance Verification

Verify patient insurance eligibility, benefits, and coverage details using online portals and direct contact with insurance companies
Determine patient financial responsibilities including co-payments, deductibles, and co-insurance
Identify and confirm in-network vs. out-of-network coverage status
Document all verification activities accurately in the company's systems
Process verification requests within established timeframes to meet service level agreements
Follow up on pending verifications to ensure timely completion

Data Management

Enter and update patient demographic and insurance information in the system
Maintain accurate and complete documentation of all verification activities
Ensure data integrity and confidentiality in accordance with HIPAA regulations
Update insurance information when changes occur
Archive and retrieve patient insurance information as needed
Generate reports on verification activities as required

Communication

Communicate effectively with insurance companies to resolve verification issues
Coordinate with the Insurance Verification Manager regarding complex cases
Document communication with insurance providers accurately
Escalate issues appropriately when unable to resolve independently
Maintain professional communication standards at all times
Participate in virtual team meetings and training sessions

Claims Support

Identify potential claim denial issues during the verification process
Flag accounts that require special attention or additional documentation
Assist with gathering information needed for clean claim submission
Support the billing team by providing verified insurance information
Help identify trends in insurance verification that may impact claims
Contribute to the development of best practices for claim submission

Quality Assurance

Adhere to established quality standards and procedures
Participate in quality improvement initiatives
Identify and report process improvement opportunities
Maintain accuracy rates that meet or exceed company standards
Complete self-audits of work as required
Contribute to team quality metrics and goals

Professional Development

Stay current with insurance industry changes and updates
Participate in training sessions to enhance skills and knowledge
Learn and adapt to new verification tools and technologies
Understand and apply updates to insurance policies and procedures
Continuously improve verification techniques and efficiency
Develop expertise in specific insurance types or verification processes

Qualifications

Education & Experience

High school diploma or equivalent required
Post-secondary education in healthcare administration or related field preferred
1+ years of experience in medical insurance verification, medical billing, or related healthcare field preferred
Experience with medical terminology and insurance concepts
Familiarity with healthcare software systems a plus
Previous experience in a remote work environment beneficial

Technical Skills

Proficient computer skills, including typing (minimum 40 WPM) and data entry
Experience with medical practice management software preferred
Ability to navigate multiple software applications simultaneously
Basic troubleshooting skills for common technical issues
Comfortable learning new software systems and technologies
Proficiency with virtual collaboration tools (video conferencing, chat, etc.)
Reliable internet connection capable of supporting video calls (minimum 10 Mbps)

Knowledge & Abilities

Understanding of health insurance plans and terminology
Knowledge of medical billing and coding concepts
Familiarity with insurance verification procedures
Attention to detail and high level of accuracy (95%+ accuracy rate expected)
Strong organizational and time management skills
Ability to work independently with minimal supervision
Problem-solving skills to resolve insurance verification issues
Self-motivated with ability to meet or exceed productivity targets
Adaptability to changing priorities and workflows

Communication Skills

Excellent written and verbal communication in English (business proficient level required)
Professional phone etiquette
Ability to explain complex insurance information clearly
Strong interpersonal skills for interacting with team members remotely
Cultural sensitivity and awareness in global communications
Ability to communicate effectively across time zones and cultural differences

Working Conditions

Fully remote position (overseas)
Flexible schedule with required overlap of at least 4 hours with US Eastern Time Zone (EST)
Must have reliable high-speed internet connection (minimum 10 Mbps) and quiet workspace
May require working early morning or evening hours depending on your local time zone
Must provide own computer equipment meeting company specifications (details provided upon hiring)
Commitment to maintaining a professional home office environment

Compensation & Benefits

Hourly rate: $6-$8 per hour, based on experience and qualifications
Performance-based incentives for exceeding productivity targets
Paid training period
Opportunities for advancement based on performance
Regular performance reviews with potential for rate increases
Flexible working hours

Reporting Relationship

Reports to: Medical Insurance Verification Manager (based in Tampa/Clearwater, Florida)
Works closely with: Other Insurance Verification Specialists, Billing Team

Application Process

Qualified candidates should submit a resume detailing their relevant experience and qualifications. Please include \"Medical Insurance Verification Specialist - Remote\" in the subject line. Candidates must be available for online interviews and skills assessments.

Preferred Locations

While this position is open to qualified candidates from various overseas locations, we have established successful remote teams in the Philippines and India. Candidates from these regions are encouraged to apply.

We are an equal opportunity employer and value diversity. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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