Insurance Verification Representative - Remote (Tri-County Area)

University of Miami; Medley (FL); Remote; USD 35,000 - 55,000; Full time

Job summary

An established industry player is seeking a dedicated Insurance Verification Representative to join their remote team. In this role, you will ensure patient satisfaction by verifying insurance eligibility and benefits, coordinating authorizations, and providing exceptional customer service. This position offers a dynamic work environment where you can grow your skills while working with a diverse patient population. If you thrive under pressure and enjoy collaborating with healthcare providers, this opportunity is perfect for you. Join a team committed to excellence in patient care and contribute to meaningful healthcare solutions.

Benefits

Medical insurance

Dental insurance

Tuition remission

Flexible work hours

Career development opportunities

Qualifications

• 1+ years of experience in Insurance Verification and Registration.
• Strong communication and teamwork skills are essential.

Responsibilities

• Verify eligibility and benefits for patient services.
• Educate patients about financial clearance and authorization processes.

Skills

Effective communication

Teamwork ability

Proactive problem-solving

Computer literacy

Ability to handle pressure gracefully

Education

High School Diploma or equivalent

Tools

EPIC

Job description

Insurance Verification Representative - Remote (Tri-County Area)

Apply locations: Medley, FL | Full-time | Posted 10 Days Ago | Requisition ID: R100085345

Current Employees:

If you are a current Staff, Faculty, or Temporary employee at the University of Miami, please log in to Workday to apply internally. Review the application tips here.

The University of Miami/UHealth Central Business Office offers a full-time remote Insurance Verification Representative position.

Core Responsibilities

1. Complete accounts promptly to support patient satisfaction and facilitate referral and authorization activities before the patient’s service date.
2. Verify eligibility and benefits via RTE in UChart, online insurance portals, telephone, or other automated sources.
3. Update insurance details in UChart, ensuring accuracy of subscriber info, policy number, and claims address.
4. Complete checklists and document co-payments.
5. Create referrals, benefit only, or preauthorization documents, noting deductible, co-insurance, and out-of-pocket benefits.
6. Meet productivity standards, QA goal of 95% or higher, and maintain a work queue current within 14 days.
7. Educate and serve as a resource for patients and healthcare providers within and outside UHealth.
8. Contact physicians and health plans to obtain necessary authorizations, submitting all required documentation.
9. Secure authorizations for facility and provider for POS 22 and POS 19 clinics; provider-only for POS 11 clinics.
10. Enter authorization info in UChart referral section.
11. Approve referrals and ensure financial clearance of visits.
12. Communicate with patients and departments regarding authorization issues or redirection.
13. Coordinate with departments and patients to gather additional info or update on authorization status.
14. Participate in process improvement initiatives (15% Customer Service).
15. Provide customer service, addressing insurance questions per departmental standards.
16. Inform patients about financial clearance and referral/authorization processes.
17. Collaborate with teams to ensure effective communication.
18. Handle service recoveries and escalations as guided by supervisors.
19. Perform other duties as assigned.

Note: This list is not exhaustive and duties may expand as needed.

Core Qualifications

Insurance Verification Representative

• High School Diploma or equivalent
• At least 1 year relevant experience
• Computer literacy; EPIC experience a plus
• Strong communication skills
• Teamwork ability
• Ability to handle pressure gracefully

Senior Insurance Verification Representative

• High School Diploma or equivalent
• Minimum 3 years direct experience in Insurance Verification and Registration
• Computer literacy; EPIC experience a plus

Minimum Qualifications

• Effective communication and teamwork skills
• Ability to work under stress with sensitivity
• High School Diploma plus 3 years of relevant experience
• Knowledge of insurance authorization/referral guidelines
• Effective verbal and written communication; bilingual skills a plus
• Ability to interact with diverse patients and provide excellent service
• Maintain composure under high stress
• Proactive problem-solving skills

Additional: Relevant education, experience, and certifications may be considered.

#LI-NN1

We offer competitive salaries and benefits including medical, dental, tuition remission, and more.

UHealth, the University of Miami Health System, is South Florida’s only university-based health system, serving over one million patients annually with top-tier research and education.