Insurance Verification Specialist

Premier Medical Resources is looking for an Insurance Verification Specialist to join our team!

Remote opportunity after 30-90 day in-person training.

• Verifying patient insurance coverage, ensuring surgery and procedures are covered by the individual’s insurance plan.
• Creating cost estimates prior to the surgery date and communicating costs to patients.
• Entering and verifying accurate data and updating patient benefit information in the Electronic Medical Records (EMR).
• Assisting front office with verification questions or concerns.
• Resolving coverage issues and updating patient EMR.
• Entering insurance coverage (co-payments, deductibles, etc.) accurately into patient EMR.
• Serving as a liaison between the patient, facility, physicians, and other departments to ensure timely and accurate financial clearance of all accounts.
• Verifying patient insurance coverage and benefits through online portals, phone calls, and other resources.
• Verifying insurance eligibility and ensuring all notifications and authorizations are completed by the surgery date.
• Identifying patient accounts based on self-pay, PPO, HMO, personal injury, workmen’s compensation or other managed care organizations.
• Collecting relevant data for eligibility and benefit verification including all ICD-10 and billable CPT codes per orders.
• Communicating with internal and external individuals to obtain information, resolve benefit issues, and ensure accurate benefit information is obtained.
• Responding to inquiries regarding patient accounts with appropriate and accurate information in a professional manner.
• Ensuring accounts are financially secured by reviewing and documenting benefits, patient responsibilities, authorization requirements, and other relevant information.
• Creating financial arrangements, alongside management, when a patient is unable to complete payment.
• Responding promptly to requests and keeping open channels of communication with physician, patient, and service areas regarding financial clearance status and resolution.
• Collaborating with billing and coding departments to ensure correct processing of claims.
• Calculating co-pay and estimated co-insurance due from patients per the individual payer contract.
• Completing high-quality work while adhering to productivity standards.
• Performing miscellaneous job‑related duties as assigned.

• Basic computer functions, technology, and Microsoft Office (Excel, Word).
• Knowledge of HIPAA, federal and state regulations.
• Ability to work independently with little or no supervision as well as function within a team.
• Knowledge of in‑ and out‑of‑network insurances, insurance verification, patient responsibility, and prior authorization processes.
• Good verbal and written communication skills, providing a great patient experience.
• Ability to work effectively in a fast‑paced environment.
• Strong knowledge of managed care, medical terminology, CPT coding, and ICD‑10.
• Use of appropriate modifiers, HIPAA regulations, and insurance verification procedures.
• Knowledge of payer guidelines including reading, understanding, and interpreting medical records and payer requirements.
• Critical thinking, problem‑solving, and decision‑making skills.
• Attention to detail, accountability, people skills, and problem solving.

• High School Diploma or GED.
• One (1) year of revenue cycle experience.
• One (1) year of experience with insurance verification in a hospital/ASC setting.

• 3 Medical Plans
• 2 Dental Plans
• 2 Vision Plans
• Employee Assistance Program
• Short‑ and Long‑Term Disability Insurance
• Accidental Death & Dismemberment Plan
• 401(k) with 2‑year vesting
• PTO + Holidays

Premier Medical Resources is a healthcare management company headquartered in Northwest Houston, Texas. Our goal is to leverage the expertise and skillsets of our employees to drive quality in all we do. We create career pathways for employees at all levels.

Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

Employment for this position is contingent upon the successful completion of a background check and drug screening.

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