Lead Insurance Verification Specialist

OU Medicine, Inc.; Oklahoma; Hybrid; USD 42,000 - 54,000; Full time

Benefits offered by this job

PTO

401(k) plan

Medical and dental plans

Job summary

OU Health is seeking an Insurance Verification Representative II for the Central Insurance Verification Clinic Team within Admitting. The role leads daily operations, performs advanced verification duties, and supports staffing, quality assurance, and training across the department.

You will ensure accurate pre-registration and eligibility checks for inpatient and outpatient services, maintain payor compliance, and communicate with physicians and case managers to resolve authorization issues.

Qualifications

• Requires advanced communication and leadership abilities.
• Strong analytical and problem-solving skills required.
• Proficiency with EMR systems and documentation standards.
• Ability to mentor and support team members.
• High level of accuracy and attention to detail is essential.

Responsibilities

• Perform pre-registration and insurance verification for inpatient and outpatient services.
• Follow scripted benefits verification and pre-certification format in the EMR and document results.
• Contact patients to confirm or obtain missing demographic information and collect cost share.
• Assign insurance plans accurately and perform electronic eligibility confirmation.
• Complete Medicare Secondary Payor Questionnaire as applicable.
• Research patient visit history to ensure payor-specific rule compliance.
• Communicate with physicians and case managers to resolve authorization issues.
• Lead daily operations and assist staff with complex verification issues.
• Monitor and reconcile reports to ensure timely processing and QA support.

Skills

Advanced communication

Leadership

Analytical skills

EMR proficiency

Mentoring

Attention to detail

Education

3+ years hospital Patient Access experience

HFMA CRCR or CHFP certification

High School Diploma or GED

Job description

OU Health is seeking an Insurance Verification Representative II for the Central Insurance Verification Clinic Team within Admitting. The role leads daily operations, performs advanced verification duties, and supports staffing, quality assurance, and training across the department.

You will ensure accurate pre-registration and eligibility checks for inpatient and outpatient services, maintain payor compliance, and communicate with physicians and case managers to resolve authorization issues.