Remote Insurance Verification Specialist I

Community Health Systems, Inc.; United States; À distance; USD 25 000 - 33 000; Plein temps

Avantages offerts par ce poste

Life Insurance/AD&D

Long-Term Disability

Short-Term Disability

Flexible Spending Accounts (Medical &

Employee Assistance Program (EAP)

Résumé du poste

Community Health Systems, Inc. is seeking an Insurance Specialist I to verify insurance eligibility and benefits, confirm authorizations, and support pre-registration for outpatient and inpatient services.

You will work to ensure payor guideline compliance and communicate clearly with patients and staff. This remote role emphasizes accuracy, timely communication, and financial clearance education for patients, highlighting responsibilities such as estimating patient financial responsibility,

Qualifications

• Education: H.S. Diploma or GED.
• 0-1 years of experience in insurance verification, medical billing, or healthcare revenue cycle.
• Strong knowledge of insurance plans and authorization requirements.

Responsabilités

• 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.
• This is a remote position.

Connaissances

Insurance verification knowledge

Attention to detail

Communication skills

Organizational skills

Multitasking

Formation

High School Diploma or GED

Outils

Microsoft Office Suite

EMR systems

Eligibility portals

Description du poste

Community Health Systems, Inc. is seeking an Insurance Specialist I to verify insurance eligibility and benefits, confirm authorizations, and support pre-registration for outpatient and inpatient services.

You will work to ensure payor guideline compliance and communicate clearly with patients and staff. This remote role emphasizes accuracy, timely communication, and financial clearance education for patients, highlighting responsibilities such as estimating patient financial responsibility,