Insurance Verification, Scheduling

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Perform real-time insurance eligibility checks and Verification of Benefits for both new and existing patients.

• Reach out to commercial and government insurance providers to confirm coverage, benefits, network participation, deductibles, copays, and pre-authorization criteria.

• Input organized coverage information into the EMR system.

• Analyze EOBs, pinpoint claim adjudication discrepancies, and investigate unpaid or improperly processed claims.

• Audit payments from payors, patient responsibilities, and adjustment codes.

• Follow up with payor representatives regarding denied or pending claims.

• Manage a high volume of inbound and outbound patient phone communications.

• Schedule, reschedule, and confirm patient appointments.

• Update patient demographics and insurance details within the EMR.

• Inform patients about out-of-pocket expenses prior to services rendered.

• Coordinate appointment schedules and manage referral intakes.

• Respond to voicemails and emails in a timely manner.

• Provide front-office administrative support while ensuring HIPAA data protection.

⛳️ Requirements

• Outstanding verbal and written communication skills in English; clear, natural, and accent-neutral spoken English is essential for calls with U.S. patients and insurance representatives.

• Demonstrated experience in executing Verification of Benefits (VOB) and interpreting Explanations of Benefits (EOBs).

• Proven ability to distinguish between In-Network and Out-of-Network coverage, as well as knowledge of Medicare, copays, deductibles, maximum out-of-pocket limits, and prior authorizations.

• At least 2 years of experience managing inbound/outbound calls and appointment scheduling in a U.S. medical office or virtual assistant capacity.

• Must be fully available to work 40 hours a week, Monday through Friday, from 8:00 AM to 5:00 PM PST.

• Proficient in navigating medical practice management software, clearinghouse portals, and VoIP phone systems.

• A dedicated, private home office equipped with a lockable door.

• Reliable high-speed primary internet and backup internet/power solutions.

• High-performance PC/Mac and noise-canceling headset are required.

• Capability to uphold strict HIPAA data security standards.

🏝️ Benefits

• Competitive compensation package.

• Opportunities for professional development and growth.

• Flexible work environment.