Remote Insurance Verification Specialist I

Community Health Systems, Inc.; Sarasota (FL); Remote; USD 25,000 - 41,000; Full time

Benefits offered by this job

PTO

Paid holidays

ICP

Group Medical

Dental & Vision

Educational Assistance

401(k) Plan

Sick Time

Life/AD&D

Disability Insurance

FSAs

EAP

Job summary

The Insurance Specialist I at Community Health Systems, Inc. works remotely to verify insurance eligibility and benefits for scheduled outpatient and inpatient services, educate patients on financial responsibilities, and ensure payor guidelines are followed.

The role emphasizes accuracy, communication, and timely processing to support financial clearance. The ideal candidate has HS diploma or GED and 0–1 years in insurance verification or healthcare revenue cycle, with strong attention to

Qualifications

• Strong knowledge of insurance plans, authorization requirements, and medical necessity guidelines.

Responsibilities

• Verifies insurance eligibility and benefits for scheduled and unscheduled services to ensure coverage and compliance with payor requirements.
• Calculates and communicates the patient's estimated financial responsibility for scheduled services.
• Identifies and ensures authorization and referral requirements are met in accordance with payor guidelines.
• Validates and documents all authorizations and referrals according to established policies.
• Reviews and determines the medical necessity of scheduled services based on payor criteria.
• Accurately documents and maintains all required records and communications in compliance with organizational standards.
• Communicates effectively and professionally with patients, physicians, and medical office staff to resolve inquiries and ensure adherence to payor requirements.
• Educates patients on insurance coverage, benefits, and financial responsibility, ensuring clear understanding.
• Processes and indexes incoming orders promptly and ensures compliance with documentation standards.
• Provides timely notification of admission or observation status per payor guidelines for inpatient and observation services.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

Insurance knowledge

Communication skills

Attention to detail

Organizational skills

Multitasking

Education

H.S. Diploma or GED

Tools

Microsoft Office Suite

EMR systems

Eligibility portals

Job description

The Insurance Specialist I at Community Health Systems, Inc. works remotely to verify insurance eligibility and benefits for scheduled outpatient and inpatient services, educate patients on financial responsibilities, and ensure payor guidelines are followed.

The role emphasizes accuracy, communication, and timely processing to support financial clearance. The ideal candidate has HS diploma or GED and 0–1 years in insurance verification or healthcare revenue cycle, with strong attention to