Sr. Insurance Verification Representative
Core
Verifies insurance eligibility and authorization for patients, facilitates reimbursement, and manages financial status classifications for a health system.
Role type
Sr. Insurance Verification Representative
Builds
Patient registration and insurance authorization workflows
Domain
Healthcare administration / Insurance verification
Deliverable
dashboards & analysis
Required skills
Insurance eligibility verification, Payer authorization, Claims processing, HMO plan management, Financial status classification, Staff training
Preferred skills
Learning agility, Technical proficiency, Teamwork
Responsibilities
Verifies insurance information with patients and contacts payers for eligibility and authorization; Adds or updates financial status classifications in systems; Contacts caregivers and patients for HMO payers to obtain authorizations and referrals; Generates and links referrals to visits once authorization is obtained; Responds to customer inquiries regarding insurance coverage and claim processing; Identifies non-contracted HMO payers and refers to proper departments; Serves as a lead and assists in training new staff.