Insurance Verify Representative - Onsite

Community Health Systems; Las Cruces (NM); On-site; USD 36,000 - 48,000; Full time

Job summary

Community Health Systems in Las Cruces, NM is seeking an Insurance Verification Representative to verify coverage and benefits for scheduled procedures and services. You will assist in obtaining prior authorizations and ensure accurate entry of insurance data to support timely reimbursement.

Join a collaborative health system where accuracy, communication, and attention to detail are essential. You will work with clinical and administrative teams to deliver a seamless patient experience and help

Qualifications

• 0-2 years of experience in insurance verification, billing, or a related role in a healthcare setting required.
• Basic knowledge of insurance terminology, eligibility verification, and authorization processes.
• Strong attention to detail and accuracy in data entry and documentation.

Responsibilities

• Verify patient insurance information including eligibility, benefits, and coverage limitations.
• Review services to determine necessary pre-certifications or authorizations.
• Coordinate with insurance providers to obtain required authorizations and prior approvals.
• Communicate insurance requirements and benefit information to patients.
• Enter and update insurance information in billing systems and medical records.
• Identify and resolve insurance discrepancies with other departments.
• Assist with resolving denied authorizations and facilitate appeals.
• Maintain regular and reliable attendance and comply with policies.

Skills

Insurance verification

Data entry accuracy

Communication skills

Healthcare software

Tools

Billing systems

EMR/EHR

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.

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.

Equal Employment Opportunity

This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.