Insurance Verification Specialist @Adapthealth Llc

[Hiring] Insurance Verification Specialist @Adapthealth Llc

Mar 28, 2025 - Adapthealth Llc is hiring a remote Insurance Verification Specialist. 💸 Salary: unspecified. 📍Location: USA.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

The Insurance Verification Specialist is responsible for learning and understanding the entire front-end process to ensure successful service for our patients. This role involves working in a fast-paced environment answering inbound calls and making outbound calls.

Develop and maintain working knowledge of current products and services offered by the company.
Review all required documentation to ensure accuracy.
Maintain extensive knowledge of different types of payer coverage and insurance policies.
Verify patient insurance coverage to ensure necessary procedures are covered accurately.
Complete insurance verification to determine patient eligibility, coverage, co-insurances, and deductibles.
Obtain pre-authorization if required by an insurance carrier and process physician orders for approval and authorization.
Resolve any issues with coverage and escalate complicated issues to a Manager.
Complete accurate patient demographic and insurance entry into EMR databases.
Enter data accurately into EMR databases, including payer, authorization requirements, and coverage limitations.
Spend extensive amounts of time on the phone or on payer websites with insurance companies.
Provide pertinent information regarding patient coverage.
Navigate through multiple online EMR systems to obtain applicable documentation.
Communicate with Customer Service and Management regarding trends with insurance companies.
Verify insurance carriers are listed in the company’s database system and request new carrier entries if needed.
Contact patients when documentation does not meet payer guidelines to provide updates and options.
Meet quality assurance requirements and other key performance metrics.
Facilitate resolution on customer complaints and problem-solving.
Pay attention to detail and demonstrate great organizational skills.
Actively listen to patients and handle stressful situations with compassion and empathy.
Be flexible with the actual work and hours of operation.
Utilize company-provided tools to maintain quality, including Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI, PECOS, and “How-To” documents.

Qualifications

Excellent customer service skills.
Analytical and problem-solving skills with attention to detail.
Decision-making abilities.
Excellent verbal and written communication skills.
Ability to prioritize and manage multiple tasks.
Proficient computer skills and knowledge of Microsoft Office.
Solid ability to learn new technologies and understand data flow through systems.
General knowledge of Medicare, Medicaid, and Commercial health plan methodologies preferred.
Ability to work well independently and as part of a group.
Ability to adapt and be flexible in a rapidly changing environment.

Requirements

High School Diploma or equivalent.
One (1) year work-related experience in health care administrative, financial, or insurance customer services, claims, billing, call center, or management regardless of industry.
Senior level requires two (2) years of work-related experience and one (1) year of exact job experience.
Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance.

Company Description

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📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

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Insurance Verification Specialist @Adapthealth Llc

Customer Service

Salary 💸 unspecified	Remote Location USA
Job Type full-time	Posted Mar 28, 2025

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📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

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[Hiring] Insurance Verification Specialist @Adapthealth Llc

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