Pediatric Insurance Verification Specialist

Children's Eye Center Of El Paso; El Paso (TX); On-site; USD 38,000 - 52,000; Full time

Job summary

The Children's Eye Center Of El Paso is seeking a dependable Insurance Verification Specialist to join our busy pediatric ophthalmology practice. This role verifies eligibility, benefits, and prior authorizations before scheduled appointments and ensures accurate patient information is recorded.

The ideal candidate communicates professionally with families and staff, is organized, and comfortable working with multiple insurance plans.

Qualifications

• Previous medical insurance verification experience is required.
• Experience in a medical office, specialty practice, or healthcare billing environment is preferred.
• Knowledge of eligibility, benefits, referrals, prior authorizations, copays, deductibles, coinsurance, and payer requirements.
• Familiarity with Texas Medicaid managed-care plans, commercial insurance, HMOs, and vision plans is a plus.
• Experience with Availity and insurance payer portals is preferred.
• Strong attention to detail and ability to recognize discrepancies before they affect patient care or billing.
• Ability to manage a high-volume workload while meeting daily deadlines.
• Strong written and verbal communication skills.
• Professional and patient when communicating with families and insurance representatives.
• Bilingual English/Spanish is highly preferred.
• Dependable attendance and the ability to work effectively as part of a team are required.

Responsibilities

• Verify eligibility, benefits, and coverage before scheduled appointments and procedures.
• Confirm copays, deductibles, coinsurance, referral requirements, plan exclusions, and other patient responsibilities.
• Obtain and track referrals and prior authorizations when required.
• Verify medical and vision benefits and determine which coverage applies to the scheduled service.
• Review insurance cards and confirm that patient and policy information is complete and accurate.
• Identify HMO, Medicaid, managed-care, commercial, self-pay, and other payer requirements.
• Confirm that the scheduled provider and facility are in network.
• Document verification details clearly and accurately in the patient's account.
• Notify scheduling and billing staff promptly of coverage concerns, authorization issues, or services that may not be covered.
• Contact parents or guardians when updated insurance information, referrals, or additional documentation is needed.
• Monitor upcoming appointments to ensure verification is completed within required timeframes.
• Assist with resolving eligibility discrepancies and insurance-related scheduling concerns.
• Maintain patient confidentiality and comply with HIPAA requirements.
• Work closely with the billing, scheduling, front-office, and clinical teams to prevent avoidable denials and delays in care.

Skills

Medical insurance verification

Communication skills

Bilingual English/Spanish

Attention to detail

HIPAA compliance

Tools

Availity

Job description

The Children's Eye Center Of El Paso is seeking a dependable Insurance Verification Specialist to join our busy pediatric ophthalmology practice. This role verifies eligibility, benefits, and prior authorizations before scheduled appointments and ensures accurate patient information is recorded.

The ideal candidate communicates professionally with families and staff, is organized, and comfortable working with multiple insurance plans.