Insurance Verification Representative - ONSITE

Community Health Systems; Knoxville (TN); On-site; USD 23,000 - 30,000; Full time

Job summary

The Insurance Verification Representative at Turkey Creek Medical Center is responsible for verifying insurance coverage and benefits for scheduled procedures, ensuring accurate patient records, and aiding in obtaining prior authorizations to support timely reimbursement.

This on-site role collaborates with clinical and administrative teams to provide a seamless patient experience and accurate billing, with attention to detail and strong communication skills required.

Qualifications

• 0-2 years of experience in insurance verification, billing, or a related healthcare role.
• Basic knowledge of insurance terminology and eligibility verification.
• Understanding of authorization processes and prior approvals.

Responsibilities

• Verify patient insurance information, eligibility, benefits, and coverage.
• Review scheduled services to determine necessary pre-certifications or authorizations.
• Coordinate with insurance providers to obtain required authorizations and prior approvals.
• Communicate insurance requirements to patients and explain coverage details.
• Enter and update insurance data in patient records and billing systems.
• Identify and resolve insurance discrepancies in collaboration with other departments.
• Assist with denied authorizations and facilitate appeals as needed.
• Perform other duties as assigned.

Skills

Insurance terminology

Eligibility verification

Authorization processes

Attention to detail

Data entry accuracy

Communication skills

Time management

Healthcare software familiarity

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.

This is not a remote postion. This position is located at Turkey Creek Medical Center and is a 100% onsite work schedule.

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.