Insurance Verification Representative

Tennova---Turkey-Creek-Medical-Center-1; Knoxville (TN); On-site; USD 36,000 - 48,000; Full time

Job summary

Tennova Turkey Creek Medical Center in Knoxville, TN, is seeking an Insurance Verification Representative to verify coverage and benefits for scheduled procedures, ensuring accuracy in patient records and facilitating timely reimbursement.

You will collaborate with clinical and administrative teams to review services for pre-certifications, obtain required authorizations, communicate requirements to patients, and maintain billing systems with a focus on accuracy and reliability.

Qualifications

• 0-2 years of experience in insurance verification, billing, or a related healthcare role.

Responsibilities

• Verifies patient insurance information, including eligibility, benefits, and coverage limitations.
• Reviews scheduled services to determine necessary pre-certifications or authorizations.
• Coordinates with insurance providers to obtain required authorizations and prior approvals.
• Communicates insurance requirements and benefit information to patients.
• Accurately enters and updates insurance information in patient records and billing systems.
• Identifies and resolves insurance-related discrepancies or issues, working with other departments as necessary.
• Assists with resolving denied authorizations and facilitates appeals as required.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Skills

Insurance terminology

Eligibility verification

Data entry accuracy

Communication skills

Time management

Computer literacy

Tools

Billing software

Job description

Job Summary

The Insurance Verification Representative is responsible for verifying insurance coverage and benefits for scheduled procedures and services. This role ensures accuracy in patient records and assists in obtaining prior authorizations, if needed, to facilitate timely reimbursement. The Insurance Verification Representative works closely with clinical and administrative teams to provide a seamless patient experience.

Essential Functions

• Verifies patient insurance information, including eligibility, benefits, and coverage limitations.


• Reviews scheduled services and procedures to determine any necessary pre-certifications or authorizations.


• Coordinates with insurance providers to obtain required authorizations and verifies prior approvals.


• Communicates insurance requirements and benefit information to patients and answers any questions related to coverage.


• Accurately enters and updates insurance information in the patient’s medical record and billing systems.


• Identifies and resolves any insurance-related discrepancies or issues, working with other departments as necessary.


• Assists with resolving denied authorizations and facilitates appeals as required.


• Performs other duties as assigned.


• Maintains regular and reliable attendance.


• Complies with all policies and standards.

Qualifications

• 0-2 years of experience in insurance verification, billing, or a related role in a healthcare setting required

Knowledge, Skills and Abilities

• Basic knowledge of insurance terminology, eligibility verification, and authorization processes.


• Strong attention to detail and accuracy in data entry and documentation.


• Effective communication and interpersonal skills for interacting with patients, staff, and insurance companies.


• Ability to manage time effectively and work in a fast-paced environment.


• Proficient in basic computer skills and comfortable navigating healthcare billing or insurance software.