Insurance Verification Specialist

Location: Remote

Type: Full-Time

Working Hours: EST Hours (6pm to 2:30 am IST)

Job Summary

You’ll be the bridge between our team and insurance providers. Your role is to verify whether a policy covers specific services, confirm acceptance, and assess coverage timelines (effective dates, renewals, gaps). You’ll deliver clear reports that help internal teams make informed decisions before proceeding.

Key Responsibilities

• Verify insurance eligibility and coverage details by contacting insurers or using portals.
• Confirm policy acceptance, exclusions, waiting periods, renewals, and lapses.
• Document effective coverage years and any history of gaps.
• Prepare clear verification reports for internal teams.
• Escalate unclear cases and provide risk assessments.
• Track policy expirations and re-verification needs.
• Liaise with billing/revenue cycle teams to secure necessary authorizations.
• Maintain updated insurer records and common verification outcomes.
• Support appeals or clarifications when insurers initially deny coverage.

Qualifications

• High school diploma required; degree in business, insurance, or healthcare admin preferred.
• Prior experience in insurance verification, medical billing, or claims processing.
• Strong communication skills for dealing with insurers and internal teams.
• Ability to interpret insurance policy documents and benefit summaries.
• Organized, detail-oriented, and comfortable managing multiple verifications at once.
• Familiarity with insurance portals, EHR, or billing/claims systems is a plus.

Nice to Have

• Certification in medical billing, coding, or insurance administration.
• Knowledge of prior authorization and credentialing workflows.
• Familiarity with common U.S. insurance carriers.