Seeking VA Insurance Expert

HealthCare Resolution Services, Inc.; Columbia (MD); On-site; USD 40,000 - 55,000; Full time

Job summary

HealthCare Resolution Services, Inc. seeks a Benefits Verification Specialist to confirm patient insurance coverage, benefits, and financial responsibility prior to services. This prevents billing surprises and protects both patients and the practice.

The role involves verifying coverage, managing authorizations, updating billing data, and resolving discrepancies by coordinating with insurers and patients. Applicants should have a high school diploma and 1–2 years in related fields.

Qualifications

• Requires good knowledge of medical terminology and CPT codes.
• 1–2 years in medical billing, insurance verification, or healthcare revenue cycles preferred.
• Familiarity with VA EHR systems and verification portals is a plus.

Responsibilities

• Verify patient insurance eligibility, active policy dates, and benefits before procedures.
• Secure pre-certifications and referrals for inpatient or outpatient care.
• Update EHR and billing systems with payer and policy details.
• Communicate with insurers and patients to resolve coverage discrepancies or cost inquiries.

Skills

Medical terminology

CPT codes

Insurance verification

Communication skills

Education

High school diploma or GED

Associate degree preferred

Tools

VistA CPRS

Billing portals

Job description

A Benefits Verification Specialist verifies patient insurance coverage, benefits, and financial responsibility before services are provided. The work prevents the worst kind of billing surprise - services delivered without coverage, leaving the patient with full financial responsibility and the practice with collection challenges. Strong benefits verification protects patients and practices both. The Specialist is the role that ensures everyone knows whats covered before care begins.

Key Responsibilities

• Verify Coverage: Check patient insurance eligibility, active policy dates, and benefits before scheduled procedures.
• Manage Authorizations: Secure pre-certifications and referrals for inpatient or outpatient care.
• Handle Billing Data: Update electronic health records and billing systems with correct payer and policy details.
• Resolve Issues: Communicate with insurance companies and patients to fix coverage discrepancies or answer cost inquiries.

Requirements and Qualifications

• Education: High school diploma or GED certificate; an associate degree is often preferred.
• Experience: Minimum 1 to 2 years of experience in medical billing, insurance verification, or healthcare revenue cycles.
• Skills: Knowledge of medical terminology and CPT codes.
• Technology: Familiarity with VA electronic health record systems and insurance verification portals. (VistA, CPRS, Integrated Billing, etc.)