Remote Insurance Verification & Authorization Specialist

Sioux Center Health; Aberdeen (SD); Remote; USD 27,000 - 35,000; Full time

Benefits offered by this job

PTO available day 1 for eligible hires

Up to 5% employer matching retirement

Career development through hands-on培训

Job summary

Avera is hiring a Insurance Eligibility Specialist to manage insurance eligibility, benefit verification, and authorization processes with payers. This role involves calculating patient estimates, educating patients on benefits, and collaborating with multiple departments to ensure proper reimbursement.

The position supports remote work within the Avera footprint and requires knowledge of payer rules, EMTALA and HIPAA compliance, with 1–3 years in billing/insurance and healthcare experience.

Qualifications

• 1–3 years of experience in billing, insurance or registration.
• 1–3 years of healthcare experience.

Responsibilities

• Process eligibility and verify full benefit coverage with insurers and employers.
• Identify payment sources and required authorizations to prevent denials.
• Obtain referrals and pre-certifications from providers and enter data into the health system.
• Calculate patient estimates and communicate financial responsibility.
• Educate patients on benefits and assist with charity applications when needed.
• Screen self-pay patients for coverage and refer to advocacy as needed.
• Ensure compliance with EMTALA and HIPAA in processes.

Skills

Insurance verification

Authorization processes

Communication skills

Financial counseling

HIPAA compliance

Education

Associate's finance, business or healthcare

Tools

Health information system

Job description

Avera is hiring a Insurance Eligibility Specialist to manage insurance eligibility, benefit verification, and authorization processes with payers. This role involves calculating patient estimates, educating patients on benefits, and collaborating with multiple departments to ensure proper reimbursement.

The position supports remote work within the Avera footprint and requires knowledge of payer rules, EMTALA and HIPAA compliance, with 1–3 years in billing/insurance and healthcare experience.