Insurance Verification Representative

Howard Head; United States; Remote; USD 28.000 - 33.000; Vollzeit

Benefits dieser Stelle

Parental leave

Housing programs

Childcare reimbursement

Tuition Assistance

Student Loan Repayment

Annual Wellness Reimbursement

Recreation discounts

Pet insurance

Retirement plan with employer match

Zusammenfassung

Howard Head Sports Medicine in the United States is seeking an Insurance Verification Representative to accurately verify benefits for patients, supporting financial clearance before services and ensuring accurate patient data for claims processing.

The role requires strong attention to payer details, HIPAA compliance, and effective communication with patients and clinical staff. It offers full-time, remote-friendly opportunities with standard daytime hours.

Qualifikationen

• One year of customer service experience preferred.
• Insurance verification or healthcare experience preferred.
• Epic experience with physical or occupational therapy workflows preferred.

Aufgaben

• Determine eligibility and benefits prior to scheduled appointments.
• Identify payer plan codes in the EHR system.
• Verify medical necessity per CMS standards and communicate coverage to patients.
• Communicate with patients, physicians, front staff, and translators.
• Identify and obtain missing patient demographic or insurance details.
• Coordinate benefits and determine primary/secondary liability.
• Obtain pre-certifications and pre-authorizations from payers.
• Escalate complex cases and notify patients of issues.
• Discuss patient financial responsibility and available financial assistance.
• Maintain HIPAA compliance throughout duties.
• Perform other duties and uphold Just Culture.

Kenntnisse

Customer service

Insurance verification

Epic experience

Ausbildung

Degree in healthcare administration

Tools

Epic

Jobbeschreibung

Explore job opportunities at Howard Head Sports Medicine.

8242 Insurance Verification

Insurance Verification Representative

New

Schedule

Schedule Full-time year-round Shift Days

Details

Company Vail Health Location Remote Category Administrative/Clerical Clinical No Close Date October 30, 2026

Pay

Hourly $20.30 – $24.19 USD

Some roles may be based outside of our Colorado office (remote-only positions). Roles based outside of our primary office can sit in any of the following states: AZ, CO, CT, FL, GA, ID, IL, KS, MA, MD, MI, MN, NC, NJ, OH, OR, PA, SC, TN, TX, UT, VA, WA, and WI. Please only apply if you are able to live and work primarily in one of the states listed above. State locations and specifics are subject to change as our hiring requirements shift.

About the Opportunity:

This role is responsible for the accurate and timely verification of insurance and benefits information for patients at Vail Health. The position plays a key role in supporting the organization’s financial health by ensuring financial clearance prior to service and maintaining accurate patient demographic and insurance information for proper claims processing.

Schedule:
This position operates on a standard schedule of 8:00 AM – 4:30 PM MST and requires adherence to this time zone regardless of location.

What You Will Do:

• Utilize online systems, phone communication, and other resources to determine eligibility and benefits prior to scheduled appointments in accordance with Vail Health timelines
• Accurately identify and assign payer plan codes in the organization’s electronic health record system
• Verify medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicate coverage and eligibility details to patients
• Communicate with patients, physicians, clinicians, front-end staff, and translators to gather any additional required information
• Identify and obtain missing patient demographic, insurance, or pre-authorization details
• Coordinate benefits by determining primary and secondary liability when applicable
• Obtain pre-certifications and pre-authorizations from third-party payers per payer requirements
• Escalate complex cases and notify patients or physician offices of any issues impacting verification or eligibility
• Communicate patient financial responsibility directly or partner with appropriate staff to review payment and financial assistance options
• Demonstrate and uphold the principles of a Just Culture
• Perform other duties as assigned; must remain HIPAA compliant

This description is not intended to be an exhaustive list of all responsibilities, skills, or working conditions, but rather an overview of the general scope of the role.

What You Will Need:

Experience:

• One year of customer service experience preferred
• Insurance verification or healthcare experience preferred

At least one year of professional experience using Epic, specifically working with and verifying Physical Therapy and/or Occupational Therapy workflows, is strongly preferred.

License(s) & Certification(s):

• N/A

Education:

• Degree in healthcare administration or a related field preferred

Benefits at Vail Health (Full-time) Include:

• Competitive Wages & Family Benefits:
  • Competitive wages
  • Parental leave (4 weeks paid)
  • Housing programs
  • Childcare reimbursement
• Medical
• Vision
• Educational Programs:
  • Tuition Assistance
  • Existing Student Loan Repayment
  • Specialty Certification Reimbursement
  • Annual Supplemental Educational Funds
• Paid Time Off:
  • Up to five weeks in your first year of employment and continues to grow each year.
• Retirement & Supplemental Insurance:
  • 403(b) Retirement plan with immediate matching
  • Life insurance
  • Short and long-term disability
• Recreation Benefits, Wellness & More:
  • Up to $1,000 annual wellbeing reimbursement
  • Recreation discounts
  • Pet insurance

Pay is based upon relevant education and experience per hour.