Insurance Verification & Referrals Expert

Cancer Center of South Florida; West Palm Beach (FL); On-site; USD 42,000 - 54,000; Full time

Job summary

Cancer Center of South Florida is seeking an Insurance Verification/Referral Specialist to ensure timely and accurate patient care by verifying insurance coverage and obtaining required referrals before services are rendered.

You will collaborate with patients, payers, and internal teams including Chemotherapy Services, Patient Access, Revenue Cycle, and clinical staff to support compliant registration and treatment processes.

Qualifications

• High school diploma or equivalent required; associate’s degree in healthcare administration, business, or related field preferred.
• Minimum of 2-3 years of experience in insurance verification and referrals with patient interaction.
• Experience with electronic medical records, practice management systems, and insurance portals required; EPIC experience preferred.

Responsibilities

• Verify insurance coverage and benefits for new and established patients using real-time eligibility (RTE), insurance portals, or phone, and ensure timely updates to the Practice Management system.
• Review registration details using the “Sidebar” checklist to confirm active insurance, patient, and guarantor status, and proper filing order for all coverages.
• Communicate eligibility issues and financial responsibilities (co-pays, co-insurance, deductibles) to patients, and answer insurance-related inquiries.
• Enter patient financial responsibility details into the payment collection or message field to inform the Patient Access Team.
• Evaluate and enter pre-payment amounts for patients receiving treatment; serve as back-up to the Patient Financial Counselor during absences.
• Initiate and obtain insurance referrals for services such as office visits, labs, phlebotomy, and port flushes; coordinate with providers and payers to resolve referral issues and ensure timely approvals.
• Maintain accurate records of all referral requests, approvals, and denials for audit and compliance purposes.
• Respond promptly to inquiries from Patient Access, Patient Services, Chemotherapy Services, and Revenue Cycle teams regarding insurance or referral matters.
• Notify Chemotherapy Services of any coverage issues that could delay treatment or impact the plan of care.
• Support AR specialists with insurance/referral denials and collaborate with Oncology Strategy and Compliance teams as needed; perform other duties as assigned.

Skills

Insurance plan knowledge

Referral coordination

HIPAA/compliance

Medical terminology

CPT/ICD-10 coding

Education

High school diploma or equivalent

Associate’s degree preferred

Tools

EPIC

EMR

Practice management systems

Insurance portals

Job description

Cancer Center of South Florida is seeking an Insurance Verification/Referral Specialist to ensure timely and accurate patient care by verifying insurance coverage and obtaining required referrals before services are rendered.

You will collaborate with patients, payers, and internal teams including Chemotherapy Services, Patient Access, Revenue Cycle, and clinical staff to support compliant registration and treatment processes.