Insurance Verification Representative

Ideal Option PLLC; Washington (District of Columbia); On-site; USD 42,000 - 60,000; Full time

Job summary

Ideal Option PLLC in Washington, DC is seeking an Insurance Verification Representative to provide exceptional patient service while ensuring accurate verification of insurance coverage. You will verify coverage through payer portals, document benefits and costs, assist with account creation and scheduling, and guide patients regarding financial responsibilities in a HIPAA-compliant setting.

The role requires strong communication, attention to detail, and proficiency with medical office software

Qualifications

• Strong verbal and written communication skills.
• Excellent customer service and attention to detail.
• Ability to multitask and work effectively in a fast-paced environment.
• Proficiency with Microsoft Office applications, including Outlook and Teams.
• Knowledge of medical office procedures and insurance processes.
• Experience with medical insurance verification is a plus.
• High School Diploma or GED preferred.

Responsibilities

• Verify patient insurance coverage and benefits through payer portals.
• Accurately process new and established patient accounts within required timeframes.
• Review and document insurance benefits, coverage limitations, copays, deductibles, and estimated patient costs.
• Notify patients of coverage issues and financial responsibilities.
• Schedule new patient appointments and assist with account-related questions.
• Maintain documentation including insurance verification and patient communications.
• Comply with HIPAA, 42 CFR Part 2, and other privacy requirements.

Skills

Communication skills

Customer service

Multitasking

Microsoft Office

HIPAA compliance

Education

High School Diploma or GED

Tools

eClinicalWorks (eCW)

Experian

Artera

Outlook

Microsoft Teams

Microsoft Office

Job description

Job Description

Description:

Purpose of Position

The Insurance Verification Representative is responsible for providing exceptional service to patients while ensuring accurate and timely verification of insurance coverage and benefits. This position supports patient experience by assisting with account creation, appointment scheduling, benefit communication, and resolution of insurance and account-related issues. This position works closely with patients and internal departments to ensure accurate information and a smooth patient experience.

Job Duties and Responsibilities

• :The following duties have been identified as essential functions of the position. Additional duties may be assigned based on organizational needs
• Verify patient insurance coverage and benefits through appropriate payer portals and
• Experian
• Accurately process new and established patient accounts within required timeframes.
• Review and document insurance benefits, coverage limitations, copays, deductibles, and estimated patient costs.
• Notify patients of coverage issues and financial responsibilities.
• Schedule new patient appointments and assist with account-related questions.
• Communicate with patients through approved methods, including
• Artera
• Direct patients to Financial Counseling for financial hardship and payment plan options when appropriate.
• Maintain accurate documentation, including insurance verification and patient communications.
• Utilize
• eClinicalWorks (eCW), Outlook, Microsoft Teams, Experian, Artera, and other department systems as required.
• Comply with HIPAA, 42 CFR Part 2, and other applicable privacy requirements.
• Maintain knowledge of insurance and billing requirements.
• Meet productivity, attendance, and performance expectations.
• Work collaboratively with team members and represent Ideal Option professionally.
• Perform other duties as assigned.

Requirements

• KNOWLEDGE, SKILLS, AND ABILITIES:Strong verbal and written communication skills.
• Excellent customer service and attention to detail.
• Ability to multitask and work effectively in a fast-paced environment.
• Ability to learn and navigate multiple computer systems and applications.
• General knowledge of medical office procedures and insurance processes.
• Proficiency with Microsoft Office applications, including Outlook and Teams.
• Knowledge of chemical dependency and its effects on individuals, families, and communities (training provided if needed).
• High School Diploma or GEDPreferred:
• AA or Equivalent Experience
• Experience with personal computers (Microsoft Suite, ability to multitask within an internet browser and/or electronic spreadsheets)
• At least 1 year of customer service experience
• At least 1 year of medical insurance verification experience
• Experience with Microsoft Office applications, eClinicalWorks, Experian, ArteraGeneral knowledge of ICD 10, CPT and HCPCS codes, and medical billing processes