Insurance Verification Representative

This is a fully remote position, open to applicants in Arizona, +22 more states.

📋 Description

• Confirm patient insurance eligibility and benefits prior to scheduled appointments.

• Utilize online platforms, phone communication, and various resources in alignment with Vail Health timelines.

• Assign payer plan codes within the electronic health record system.

• Validate medical necessity in accordance with CMS standards.

• Relay coverage and eligibility information to patients.

• Collect additional details from patients, physicians, clinicians, front-end staff, and translators.

• Acquire missing demographic, insurance, and pre-authorization information.

• Coordinate both primary and secondary payer responsibilities.

• Secure payer pre-certifications and pre-authorizations.

• Elevate complex cases and inform patients or physician offices of verification or eligibility challenges.

• Communicate patient financial obligations and facilitate discussions regarding payment or financial assistance.

• Adhere to Just Culture principles and maintain compliance with HIPAA regulations.

• Execute other assigned duties as needed.

⛳️ Requirements

• A minimum of one year of customer service experience is preferred.

• Prior experience in insurance verification or healthcare is preferred.

• At least one year of professional experience with Epic, particularly in verifying Physical Therapy and/or Occupational Therapy workflows, is strongly preferred.

• A degree in healthcare administration or a related discipline is preferred.

• Must be able to reside and work primarily in one of the specified states: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kansas, Massachusetts, Maryland, Michigan, Minnesota, North Carolina, New Jersey, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, or Wisconsin.

• Must comply with the 8:00 AM–4:30 PM MST schedule, regardless of location.

• Must maintain HIPAA compliance at all times.

🏝️ Benefits

• Competitive wages.

• Parental leave (4 weeks paid).

• Housing assistance programs.

• Childcare reimbursement.

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Tuition assistance.

• Existing student loan repayment options.

• Reimbursement for specialty certification.

• Annual supplemental educational funds.

• Up to five weeks of paid time off in the first year, increasing each year thereafter.

• 403(b) retirement plan with immediate matching contributions.

• Life insurance coverage.

• Short- and long-term disability insurance.

• Up to $1,000 annual wellbeing reimbursement.

• Discounts for recreational activities.

• Pet insurance options.