Job Details

Insurance Verification Specialist

Monday - Friday - Flexible Schedule

Position Summary: The Insurance Verification Specialist is responsible for obtaining and managing insurance authorizations, verifying patient insurance coverage, and ensuring timely approval of services. This role works closely with insurance carriers, healthcare providers, and internal teams to minimize authorization delays and resolve denials efficiently.

Key Responsibilities:

• Verify patient insurance eligibility, benefits, and coverage requirements.
• Submit authorization and pre-authorization requests to specific insurance payors according to payer guidelines.
• Obtain and retrieve insurance authorizations in a timely manner to prevent delays in patient care and services.
• Monitor authorization status and follow up with insurance companies to ensure approvals are received before service dates.
• Work authorization pending reports and proactively resolve outstanding authorization requests.
• Investigate, appeal, and resolve authorization denials by communicating with insurance carriers and clinical staff.
• Maintain accurate documentation of authorization requests, approvals, denials, and payer communications.
• Ensure compliance with payer policies, healthcare regulations, and company procedures.
• Communicate authorization outcomes and coverage information to relevant departments.
• Maintain productivity and quality standards while meeting departmental turnaround time goals.

Qualifications:

• Education: High School Diploma or GED, required. 2 Year / Associate Degree, preferred.
• Experience:
• Minimum one year in patient access, registration, billing, insurance and/or pre-certification, any call center or customer service experience, required.
• Experience with insurance carriers or third party administrators is preferred.
• Additional Skills (required):
• Excellent interpersonal and communication skills, experience and competency in customer relation skills in a professional environment. Ability to organize and prioritize work in a stressful environment. Ability to work effectively/productively as a member of a team and is self-directed in a remote work environment in various types of environments (e.g. onsite corporate locations, remote/home office).
• Good problem solving skills. Basic medical terminology. Exemplary keyboarding skills and experience in patient registration systems (i.e. Epic) and familiarity with personal computers. Ability to perform several tasks simultaneously. Ability to drive/travel to multiple locations/facilities as needed.
• Ability to understand how job performance affects the outcomes of key performance indicators such as denials and write-offs.

What We're Looking For:

At Novant Health, we believe remarkable care starts with compassion for our patients, our communities, and each other. We value belonging, courage, personal growth, and teamwork, creating a space where everyone is respected, supported, and safe to show up as their full selves.

Job Opening ID 178917