Insurance Verification Specialist - Remote

Overview

The Insurance Verification Specialist at Community Medical Services will verify client eligibility on various Medicaid, Medicare, and Commercial Provider Portals while maintaining enrollment and demographic processing.

In Short

• Schedule: 6AM - 2PM - hybrid (2 days in office and 3 days remote)
• Verify client eligibility on various insurance portals.
• Maintain enrollment and demographic processing in EHR and EMR.
• Create and submit demographics to applicable payers.
• Research rejected claims and resolve discrepancies.
• Communicate with Operations and Clinical staff for error resolution.
• Perform audits on member data.
• Identify opportunities for process improvement.
• Respond to inquiries via Microsoft Outlook.
• Work in a supportive and professional development-focused environment.

Requirements

• High school diploma or equivalent.
• 3+ years of experience in transaction processing or related healthcare experience.
• Experience in managed care preferred.
• Comfortable reviewing large volumes of client records.
• Familiarity with business rules in multiple states.

Benefits

• Subsidized medical, dental, and vision insurance.
• Health savings account.
• Short and long-term disability insurance.
• Life insurance.
• Paid sick, vacation, and holiday time.
• 401K retirement plan with match.
• Tuition and CME reimbursement up to 100%.
• Employee assistance program.
• Ongoing professional development.