Medical Insurance Verification Specialist – Registered Nurse, Orthopedics

This is a fully remote position, open to applicants in Colombia, +5 more countries.

📋 Description

• Manage a high volume of inbound and outbound patient calls, which include inquiries from new patients, clinical triage follow-ups, addressing missed opportunities, and re-engaging inactive patients.

• Transform patient inquiries into scheduled appointments and maintain consistent follow-up until the conversion is achieved.

• Confirm active insurance coverage and interpret complex details of various plans.

• Calculate the financial responsibilities of patients, encompassing deductibles, copays, coinsurance, and out-of-pocket maximums.

• Clearly communicate patients' insurance coverage and associated costs during phone interactions.

• Handle various commercial plans, including HMO/PPO, Aetna, Cigna, and Humana, in addition to Medicare and Workers' Compensation/PIP.

• Oversee provider calendars efficiently.

• Maintain documentation for follow-up activities.

• Establish and nurture rapport with patients.

• Assist in business development and outreach to referral sources.

⛳️ Requirements

• Current and valid Registered Nurse (RN) license.

• Demonstrated experience in managing a high volume of inbound and outbound calls in a fast-paced medical office environment in the U.S.

• Comprehensive operational knowledge of insurance verification, including the ability to analyze coverage details beyond mere eligibility.

• Experience in phone-based patient conversion, sales, or customer engagement within a metrics-oriented setting.

• Exceptional, clear, and confident phone presence in English, characterized by a warm, energetic, and professional customer service approach.

• At least 1 year of direct experience with eClinicalWorks (eCW).

• This is a full-time contractor role requiring a commitment of 40 hours per week.

• Work schedule is Monday through Friday, from 8 am to 5 pm EST.

🏝️ Benefits

• Competitive compensation package.

• Opportunities for professional development and growth.

• Supportive work environment with a focus on team collaboration.