Insurance Specialist - REMOTE

Our Benefits

As an Insurance Specialist at Community Health Systems (CHS) - Shared Business Operations, you’ll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including:

• PTO
• Paid holidays
• Employee Incentive Program (ICP)
• Group Medical, Dental, & Vision
• Educational Assistance
• 401(k) Plan
• Sick Time
• Life Insurance/Accidental Death and Dismemberment
• Long-Term and Short Term Disability
• Medical and Child Care Flexible Spending Accounts
• Employee Assistance Program (EAP)

The Insurance Specialist I is responsible for verifying insurance eligibility and benefits, ensuring authorization requirements are met, and completing pre-registration processes for scheduled outpatient and inpatient services. This phone based role ensures compliance with payor guidelines and provides timely and accurate communication with patients, providers, and medical office staff. The Insurance Specialist I supports the financial clearance process by educating patients on insurance benefits and financial responsibilities while maintaining high standards of accuracy and professionalism.

As an Insurance Specialist I at Community Health Systems (CHS) - SSC Sarasota, you’ll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical insurance, dental insurance, vision insurance, PTO, 401K, sick time, holidays, and bonus where eligible.

• Verifies insurance eligibility and benefits for scheduled and unscheduled services to ensure coverage and compliance with payor requirements.
• Calculates and communicates the patient’s estimated financial responsibility for scheduled services.
• Identifies and ensures authorization and referral requirements are met in accordance with payor guidelines.
• Validates and documents all authorizations and referrals according to established policies.
• Reviews and determines the medical necessity of scheduled services based on payor criteria.
• Accurately documents and maintains all required records and communications in compliance with organizational standards.
• Communicates effectively and professionally with patients, physicians, and medical office staff to resolve inquiries and ensure adherence to payor requirements.
• Educates patients on insurance coverage, benefits, and financial responsibility, ensuring clear understanding.
• Processes and indexes incoming orders promptly and ensures compliance with documentation standards.
• Provides timely notification of admission or observation status per payor guidelines for inpatient and observation services.
• Performs other duties as assigned.
• This is a phone based role.
• This is a remote position.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Required:
• Education: H.S. Diploma or GED
• Experience: 0-1 years of experience in insurance verification, medical billing, or healthcare revenue cycle

• Strong knowledge of insurance plans, authorization requirements, and medical necessity guidelines.
• Proficiency in Microsoft Office Suite and healthcare information systems (e.g., EMR, eligibility portals).
• Excellent attention to detail and organizational skills.
• Strong communication and interpersonal skills to interact effectively with patients and healthcare professionals.
• Ability to work in a fast-paced environment and manage multiple priorities effectively.

We know it’s not just about finding a job. It’s about finding a place where you are respected, valued and where your work is purposeful and…