Insurance Verifier & Pre-Access Specialist

DHR Health; McAllen (TX); On-site; USD 40,000 - 60,000; Full time

Job summary

DHR Health in McAllen, TX is seeking an Insurance Verifier for Pre-Access Services. The role reviews insurance information to determine eligibility for registration and financial status, supporting accurate patient admissions and billing processes.

Qualifications include a high school diploma or GED, 1 year billing experience, and strong communication skills. The position emphasizes HIPAA compliance and proficient use of verification systems.

Qualifications

• High school diploma or GED required.
• 1 year billing experience required.
• Experience in claims filing or hospital setting preferred.
• Good written and verbal communication skills required.
• Ability to read, write and speak English.

Responsibilities

• Promotes the facility mission, vision and values.
• Determines hospital privileges by checking active medical staff listings.
• Determines financial status and eligibility for registration by reviewing insurance information.
• Obtains patient demographic and insurance information, diagnoses and procedures.
• Explains rates and hospital policy regarding payment of bills.
• Communicates information about scheduled procedures to departments and staff.
• Obtains insurance details including benefit information, policy and group numbers.
• Obtains pre-certification when needed and contacts third-party payers for coverage dates and network info.
• Verifies insurance eligibility and benefits using verification systems.
• Ensures adherence to HIPAA/PHI confidentiality and privacy requirements.
• Documents patient information clearly in accounting systems.
• Performs other duties as assigned.

Skills

English proficiency

Communication skills

PC/software proficiency

Billing experience

Education

High school diploma or GED

Tools

TMHP

IVANS

FISS

Availity

Job description

DHR Health in McAllen, TX is seeking an Insurance Verifier for Pre-Access Services. The role reviews insurance information to determine eligibility for registration and financial status, supporting accurate patient admissions and billing processes.

Qualifications include a high school diploma or GED, 1 year billing experience, and strong communication skills. The position emphasizes HIPAA compliance and proficient use of verification systems.