Experienced Intake / Verification Specialist

Hirebridge; Town of Texas (WI); Remote; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a dedicated Intake/Verification Specialist to join their remote team. The ideal candidate will have a strong background in benefit verification and authorization, with excellent communication skills and a commitment to compliance with healthcare regulations. This role offers an opportunity to work from home while contributing to a mission-driven organization that values innovation and quality care. With a comprehensive benefits package, including health insurance and a 401K plan, this position is perfect for a motivated individual looking to make a positive impact in the healthcare industry.

Benefits

Health Insurance

Vision Insurance

Dental Insurance

401K Plan with Employer Match

Long-term Disability Insurance

Life Insurance

Vacation Package

Work-from-home

Growth Opportunities

Qualifications

• 3+ years of intake/verification experience in healthcare.
• Proficiency in Microsoft Office and EHR systems.

Responsibilities

• Verify patient insurance eligibility and benefits across various payers.
• Document all calls and interactions per SOPs while adhering to HIPAA.

Skills

Benefit Verification

Authorization Processes

Communication Skills

Data Entry

Microsoft Office

Education

High School Diploma or GED

3-5 years of healthcare industry experience

Job description

Experienced Intake / Verification Specialist

Please only apply if you have at least 3 years of intake / verification experience — this is a remote opportunity.

AIS Healthcare is a leading provider of Targeted Drug Delivery (TDD) and Infusion Care solutions. Committed to advancing quality and improving lives, we value innovation, stewardship, and unity, and strive to enhance the entire care experience through quality products and services.

We are seeking an experienced and motivated benefit verification and authorization expert to join our dynamic team. The ideal candidate will possess excellent communication skills, in-depth knowledge of collection practices, and compliance with federal and state regulations related to benefit verification and authorization activities.

Benefits include health, vision, and dental insurance; long-term disability and life insurance; a vacation package; a 401K plan with a generous employer match; 100% work-from-home; growth opportunities; and more!

Education and Experience:

• High school diploma or GED required.
• 3-5 years of healthcare industry experience preferred.
• Experience in Home Infusion and Intrathecal Pain Management is a plus.

Essential Duties and Responsibilities:

• Knowledge of patient insurance eligibility and benefits processes across various payers such as Aetna, Cigna, BCBS, Humana, Worker’s Comp, Medicare, and Medicaid.
• Understanding of authorization processes including GAPs, pre-determinations, PCP referrals, and single case agreements.
• Accurate data entry of insurance and authorization information into EHR systems following SOPs.
• Follow-up on pending or expired authorizations and referrals.
• Review authorization denials for accuracy and initiate appeals until resolved or decision is made to discontinue.
• Document all calls and interactions per SOPs.
• Respond timely to all quality reviews.
• Respect patient rights and confidentiality, adhering to HIPAA regulations.
• Maintain knowledge of NDC numbers, infusion supplies, insurance plans, medical terminology, billing procedures, regulations, and codes.
• Share knowledge with team members and foster a respectful, positive work environment.
• Perform additional duties as assigned.

Qualifications:

• Ability to evaluate complex situations and exercise good judgment within legal and regulatory frameworks.
• Excellent communication and relationship-building skills, with the ability to prioritize and negotiate with stakeholders.
• Strong integrity, credibility, and work ethic.
• Self-directed, detail-oriented, organized, and reliable.
• Proficiency in Microsoft Office (Outlook, Word, Excel).

Application Process:

Complete the required Culture Index Candidate Assessment as part of your application. Applications without this step will not be considered.

Why do we use the Culture Index Assessment? It helps us match candidates' traits and skills to the right roles, ensuring a good fit and successful employment.

To complete the assessment, follow the instructions provided in the job posting. AIS Healthcare is dedicated to providing a supportive, impactful work environment for positive, earnest, and hardworking individuals.