Remote Insurance Verification and Authorization Coordinator

Actalent; Reno (NV); Remoto; USD 22.000 - 31.000; Tempo integral

Benefícios oferecidos por esta vaga

Medical, dental & vision

401(k)

Paid time off

Resumo da vaga

Actalent is seeking an Insurance Verification Coordinator for a fully remote role based out of Reno, NV. You will verify insurance eligibility and benefits, gather and submit prior authorizations, and support patients, providers, and payors to ensure accurate coverage and timely access to prescribed therapies.

The role requires 1+ year in medical billing/verification or a related degree, strong communication, and the ability to handle a high-volume referral queue with 95%+ quality.

Qualificações

• At least 1 year of medical billing or insurance verification experience, or a bachelor's degree as a substitute.
• Experience obtaining insurance benefits directly from health plans and communicating them to patients.
• Experience submitting prior authorizations to payors with clinical documentation.
• Knowledge of verification, benefit verification, and coordination of benefits processes.
• Familiarity with Medicare and commercial plans.
• Proficiency with data entry and electronic systems for documenting eligibility and communication.
• Strong customer service skills with professional and empathetic communication.
• Ability to handle high-volume referrals with quality ≥95%.
• Attention to detail in benefits review, data entry, and documentation.
• Ability to troubleshoot eligibility, coverage, and claim rejections.

Responsabilidades

• Verify insurance eligibility and benefits for services and medications and document in the system.
• Perform prior authorizations with required documentation in collaboration with offices and payors.
• Collect and record clinical information to support coverage and authorization decisions.
• Determine patient financial responsibility based on coverage (copays, coinsurance, deductibles).
• Coordinate benefits for referrals to ensure correct primary/secondary billing.
• Ensure Medicare assignments of benefits comply with payor requirements.
• Communicate with payors regarding therapies, coverage issues, and claims questions.
• Document all relevant communications with patients, physicians, and insurance companies.
• Identify patient financial assistance resources and programs.
• Handle inbound calls providing clear and accurate information.
• Research and resolve claim rejections; escalate as needed.
• Process a high volume of referrals daily from an internal queue.
• Meet or exceed performance metrics and maintain reliability.

Conhecimentos

Insurance verification experience

Medical billing knowledge

Prior authorization processes

Coordination of benefits

Communication with patients/providers/

Data entry accuracy

High-volume referral handling

Documentation and record-keeping

Customer service excellence

Attention to detail

Formação

High school diploma

Bachelor's degree in a related field (substitute for experience)

Ferramentas

Prior authorization systems

Electronic health records (EHR) systems

Descrição da vaga

Actalent is seeking an Insurance Verification Coordinator for a fully remote role based out of Reno, NV. You will verify insurance eligibility and benefits, gather and submit prior authorizations, and support patients, providers, and payors to ensure accurate coverage and timely access to prescribed therapies.

The role requires 1+ year in medical billing/verification or a related degree, strong communication, and the ability to handle a high-volume referral queue with 95%+ quality.