Insurance Verification Specialist

Centene; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a dedicated individual to join their team in transforming healthcare for millions. This role involves verifying insurance information, handling prior authorizations, and ensuring seamless communication with patients and providers. With a focus on flexibility, the company offers various work schedules, including remote options. Join a diverse and inclusive environment where your contributions will make a real difference in the lives of others. If you have a passion for healthcare and a knack for detail, this opportunity could be your next career move.

Benefits

Health Insurance

401K

Tuition Reimbursement

Paid Time Off

Flexible Work Schedules

Qualifications

• 1+ years of medical billing or insurance verification experience required.
• Experience with payors and prior authorization preferred.

Responsibilities

• Obtain and verify insurance eligibility and document complete information.
• Perform prior authorizations and coordinate with physician offices.
• Handle inbound calls and resolve claim rejections.

Skills

Insurance Verification

Medical Billing

Prior Authorization

Patient Communication

Education

High School Diploma

Bachelor's Degree in Related Field

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Obtain and verify complete insurance information, including the prior authorization process, copay assistance, and coordination of benefits.

1. Shift will be 12:00pm - 9:00pm EST
2. Obtain and verify insurance eligibility for services provided and document complete information in system
3. Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
4. Collect any clinical information such as lab values, diagnosis codes, etc.
5. Determine patient’s financial responsibilities as stated by insurance
6. Configure coordination of benefits information on every referral
7. Ensure assignment of benefits are obtained and on file for Medicare claims
8. Bill insurance companies for therapies provided
9. Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
10. Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third-party assistance programs, and manufacturer assistance programs
11. Handle inbound calls from patients, physician offices, and/or insurance companies
12. Resolve claim rejections for eligibility, coverage, and other issues
13. Performs other duties as assigned
14. Complies with all policies and standards

Education/Experience: High school diploma with 1+ years of medical billing or insurance verification experience. Bachelor’s degree in related field can substitute for experience. Experience with payors and prior authorization preferred.

Pay Range: $15.58 - $26.73 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field, or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.

About the company

Centene Corporation is a publicly traded managed care company based in St. Louis.