Ambulatory Insurance Verifier — Patient Access Pro

DHR Health; Edinburg (TX); On-site; USD 36,000 - 48,000; Full time

Job summary

DHR Health in Edinburg, TX is seeking an Insurance Verifier for Ambulatory Patient Access. The role involves determining insurance eligibility, reviewing coverage details, and communicating benefits to patients and providers.

The position requires knowledge of insurance processes, strong communication skills, and the ability to work in a fast-paced ambulatory setting. Bilingual English/Spanish is preferred; proficient with Microsoft Office and insurance portals.

Qualifications

• High School Diploma/ GED is required.
• Comprehensive understanding of insurance benefits, referral requirements, reimbursement and medical terminology.
• Ability to work with geriatric patients in a high volume fast paced practice.
• Computer skills required with knowledge of Microsoft Office suite, and the internet.
• Excellent written and verbal communication skills required.
• Bilingual – English/Spanish – preferred

Responsibilities

• Verifies benefits and eligibility for referrals and authorizations on a daily basis.
• Assists billing staff with researching accounts with discrepancies in payments, rejections and/or denials.
• Handles calls from patients, physicians, ins. carriers and ancillary providers with questions concerning referrals and authorizations.
• Confirms billing address, in and out of network benefits and maximum coverage for services being provided.
• Uses knowledge of ins. carrier requirements to give appropriate information to each carrier.

Skills

Insurance verification

Communication skills

Bilingual – English/Spanish

Microsoft Office

Medical terminology

Education

High School Diploma/GED

Tools

TMHP

Availity

Practice management software

Job description

DHR Health in Edinburg, TX is seeking an Insurance Verifier for Ambulatory Patient Access. The role involves determining insurance eligibility, reviewing coverage details, and communicating benefits to patients and providers.

The position requires knowledge of insurance processes, strong communication skills, and the ability to work in a fast-paced ambulatory setting. Bilingual English/Spanish is preferred; proficient with Microsoft Office and insurance portals.