Insurance Verification Representative

CCS

Houston (TX)

On-site

USD 40,000 - 50,000

Full time

5 days ago

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Benefits offered by this job

Competitive salary

Bonus/incentive opportunities

Comprehensive benefits

Job summary

CCS is seeking a Verification Representative to deliver first‑class customer service in our call center while qualifying patients’ insurance coverage and ensuring orders are accurate prior to shipment.

Responsibilities include verifying government and commercial coverage, communicating with teams, and supporting timely billing with a strong emphasis on HIPAA regulations and confidentiality.

Qualifications

High School diploma.
One year of customer service experience is required.
One year of medical insurance verification experience or equivalent background.
Strong knowledge of billing procedures and insurance reimbursement.
Proficient in Microsoft Outlook, Word, Excel, PowerPoint.

Responsibilities

Make outbound calls to insurance companies to verify benefits.
Evaluate coverage to determine compatibility with the program and recommend products.
Verify, review, document and complete insurance verifications.
Identify and request documentation to enable timely billing.
Review patient accounts and determine actions to collect payments.
Review claims and perform corrections/submissions to new carriers.
Maintain knowledge of billing procedures, HCPC codes, and reimbursements.
Ensure confidentiality of sensitive information.
Maintain attendance and flexibility to meet department needs.
Follow Medicare, Medicaid, HIPAA, and private insurance regulations.

Education

High School diploma

Job description

Overview

Are you looking for a purposeful career that will make a difference in the patient community? At CCS, our approach to at-home patient care is redefining chronic care management. We are seeking individuals that will thrive in a patient‑centric dynamic environment. If you are an attentive listener, fast‑thinker, and problem‑solver, with the ability to relate to different people, you are a match for CCS. As a Verification Representative, you’ll be at the heart of our operations as you deliver first‑class customer service in every interaction in our call center. You will be responsible for qualifying patients’ insurance coverage and ensures patient orders are accurate and complete prior to shipment claim. The verification representative will verify coverage for governmental, commercial insurance companies and patient accounts. You’ll be the one‑of‑our subject‑matter experts that will help us solve our patient’s challenges‑and deliver on our promise of superior customer service.

Alaska, California, Colorado, Delaware, Hawaii, Idaho, Maine, Montana, Nevada, New Hampshire, New York, North Dakota, Rhode Island, South Dakota, Vermont, Washington, Wyoming , Illinois ; residents are not eligible.

Responsibilities

Makes outbound calls to insurance companies to verify insurance benefits
Evaluates insurance coverage in order to determine the policy’s compatibility with our program and recommends the appropriate products based on the patient’s needs and insurance coverage
Efficiently and accurately verifies, reviews, documents and completes insurance verifications
Identifies and initiates documentation needs and requests to permit timely billing of services and communication with appropriate team(s)
Reviews patient accounts and determines appropriate action(s) needed to collect payment
Reviews claims and performs claim corrections and submissions to new carrier based on new plan verification
Has a strong working knowledge of billing procedures, insurance reimbursement procedures and HCPC codes
Ability to analyze and correct accounts receivable problems
Maintains a high degree of confidentiality always due to access to sensitive information
Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
Follows all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements

Qualifications

High School diploma
One-year medical insurance verification related experience or equivalent combination of education and experience
One year of customer service experience required
Has a strong working knowledge of billing procedures, insurance reimbursement procedures and HCPC codes
Ability to analyze and correct accounts receivable problems
Proficient in Microsoft Outlook, Word, Excel, PowerPoint and computer literacy
Knowledge of government and commercial insurance payers as it relates to documentation of claims that are required before submission
Ability to understand Medical Records documents
Position may require evening and weekend availability

Values

Certainty-The lives of the individuals we serve depend on our ability to execute. We commit to doing this every day.

Use appropriate methods and a flexible interpersonal style to help build a cohesive and collaborative team based on a foundation of trust and transparency. Deliver what you commit to.

Compassion-We understand the burdens of patients and their loved ones and channel this into a relentless pursuit of customer satisfaction in every part of our business.

Ensure that the patient is the driving force behind business decisions, implementing service practices that meet needs of both the patient and the organization. Treat others the way you want to be treated.

Advancement-We are endlessly looking for ways to progress and become more innovative in all things we do.

Encourage innovative approaches for addressing opportunities and facilitating change, driving cross‑functional alignment to accomplish goals. Speak the truth.

CCS Medical and EEOC/AA employer. M/F/D/V

Company Overview

CCS is the strategic partner addressing America's most pressing healthcare challenges through intelligent chronic care management, tackling the $412 billion annual diabetes burden and chronic conditions affecting over 133 million Americans. At the core of CCS's differentiated model is LivingConnected®, a human‑led, digitally‑enabled clinical solution. PropheSee™—an AI‑powered predictive model that identifies non‑adherence risk and delivers personalized interventions— is an integral part of this solution, creating a first‑of‑its‑kind platform to improve adherence, enhance clinical outcomes, and help prevent costly hospitalizations. By combining data‑driven insights with three decades of industry relationships, CCS is the smart choice for health plans, providers, employers, and manufacturers who believe that value‑based care starts by keeping patients healthy and delivers benefits like lower cost of care, improved HEDIS scores, and alleviating provider burnout. CCS's approach extends clinical reach while supporting over 200,000 people nationwide with home‑delivered medical supplies and pharmaceuticals annually. Recognized as a Great Place to Work®, and with numerous peer‑reviewed publications validating our care management approach, CCS is more than a trusted supplier—we're a partner in transforming chronic care delivery. To learn more about how CCS is addressing today's healthcare challenges, visit ccsmed.com or connect with us on LinkedIn.

What We Offer