Remote Home Health Insurance Verification Specialist

Apex Systems; Stone Ridge (NY); Remote; USD 24,000 - 32,000; Part time

Job summary

Apex Systems seeks a Part Time Home Health Insurance Verification Specialist for a 1-year contract. This remote, 20-hour-per-week role supports admissions and patient care by verifying insurance coverage across Medicare, Medicaid, and commercial plans.

You will use Epic and payer portals to confirm eligibility, review authorization requirements, resolve discrepancies, and document findings in the EMR, collaborating with clinicians and case managers.

Qualifications

• 3+ years of healthcare insurance verification, patient access, revenue cycle, or related healthcare operations experience.
• Epic experience.
• Experience verifying Medicare, Medicaid, Medicare Advantage, and commercial insurance plans.
• Strong understanding of insurance eligibility, benefits verification, authorizations, and reimbursement processes.
• Experience working with payer portals and eligibility verification tools.
• Exceptional attention to detail and commitment to accuracy.
• Strong communication and customer service skills.
• Ability to work independently in a remote environment.
• Strong organizational and problem-solving skills.

Responsibilities

• Perform comprehensive insurance eligibility and benefits verification prior to admission and throughout the patient care lifecycle.
• Verify Medicare, Medicare Advantage, Medicaid, Medicaid Managed Care, commercial insurance, hospice coverage, self-pay accounts, and specialty program eligibility.
• Review payer-specific requirements, authorization requirements, coverage limitations, and reimbursement methodologies.
• Utilize Epic and multiple payer portals to validate coverage, eligibility, and authorization status.
• Determine primary and secondary payer responsibility and ensure accurate billing pathways.
• Research and resolve insurance discrepancies, coverage changes, policy terminations, and authorization issues.
• Document verification findings and payer communications accurately within the EMR.
• Monitor and manage assigned work queues to ensure timely completion of verification activities.
• Partner with clinicians, case managers, and operational teams regarding coverage, eligibility, and reimbursement impacts.
• Identify reimbursement risks and proactively communicate concerns to appropriate stakeholders.
• Support audits, compliance efforts, and payer-related investigations as needed.
• Maintain productivity, quality, and accuracy standards while managing a high-volume workload.

Skills

Healthcare insurance verification

Eligibility & benefits verification

Authorization management

Payer portal navigation

Attention to detail

Remote work capability

Tools

Epic EMR

Job description

Apex Systems seeks a Part Time Home Health Insurance Verification Specialist for a 1-year contract. This remote, 20-hour-per-week role supports admissions and patient care by verifying insurance coverage across Medicare, Medicaid, and commercial plans.

You will use Epic and payer portals to confirm eligibility, review authorization requirements, resolve discrepancies, and document findings in the EMR, collaborating with clinicians and case managers.