Insurance Verification Specialist

Delaware Orthopaedic Specialists; Wilmington (DE); On-site; USD 40,000 - 55,000; Full time

Benefits offered by this job

401(k)

Dental insurance

Health insurance

Paid time off

Vision insurance

Job summary

Delaware Orthopaedic Specialists is seeking an Insurance Verification Specialist located in Wilmington, DE. This role involves verifying patient insurance details, ensuring coverage before appointments, and assisting patients with their insurance queries. Ideal candidates will have knowledge of insurance processes and strong communication skills. The position offers a work environment that emphasizes accuracy and collaboration with clinical teams, representing an excellent opportunity in the healthcare sector.

Qualifications

• Strong understanding of insurance verification, including eligibility checks and prior authorizations.
• Experience using insurance portals and verification tools is highly desirable.
• Prior experience in insurance verification or healthcare revenue cycle preferred.

Responsibilities

• Verify patient insurance eligibility and benefits prior to appointments.
• Contact insurance carriers to confirm active coverage.
• Document verification details in the practice management system.

Skills

Insurance verification processes

Microsoft Office

Strong organizational skills

Effective communication skills

Medical terminology knowledge

Education

High School Diploma or GED

Tools

Practice management systems

Job description

Overview

Job Title: Insurance Verification Specialist. Reports To: Phone Room Manager. Job Location: Wilmington, DE 19803. Hours/Week: 40.

Responsibilities

• Verify patient insurance eligibility, benefits, and coverage details prior to appointments, including copays, deductibles, referrals, and authorization requirements.
• Contact insurance carriers via phone or online portals to confirm active coverage and obtain necessary information.
• Accurately document verification details in the practice management system.
• Identify and communicate any coverage issues, discrepancies, or authorization requirements to appropriate staff and/or patients.
• Collect, enter, and update patient demographic and insurance information with a high degree of accuracy.
• Assist patients in understanding their insurance coverage, financial responsibilities, and referral requirements when applicable.
• Triage incoming calls and route them appropriately to clinical or administrative staff.
• Collaborate with front desk, billing, and clinical teams to resolve insurance-related issues.
• Maintain compliance with HIPAA and all applicable privacy regulations.
• Provide exceptional customer service in all patient interactions.

Qualifications

• Job Knowledge and Skills
• Strong understanding of insurance verification processes, including eligibility checks, benefits, referrals, and prior authorizations.
• Familiarity with commercial insurance plans, Medicare, Medicaid, and managed care plans preferred.
• Proficiency in Microsoft Office (Word, Outlook, Excel) and practice management systems.
• Experience using insurance portals and verification tools is highly desirable.
• Excellent attention to detail and strong organizational skills.
• Effective communication skills, with the ability to explain insurance information clearly to patients.
• Ability to multitask in a fast-paced environment while maintaining accuracy.
• Working knowledge of medical terminology preferred.
• Reliable, self-motivated, and able to work both independently and as part of a team.
• Must consistently monitor and respond to email communications in a timely manner.

• Education
• High School Diploma or GED required; additional healthcare or administrative training is a plus.

• Experience
• Prior experience in insurance verification, medical front office, or healthcare revenue cycle preferred.
• Experience in an orthopaedic or specialty practice is a plus but not required.

Benefits

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person