Insurance Verification Specialist

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a dedicated Medical Insurance Verification Specialist to join their team. The primary responsibilities include verifying patient insurance eligibility and benefits, ensuring compliance with HIPAA and hospital privacy policies, and providing exceptional customer service in a fast-paced call center environment.

Key Responsibilities

• Verify patient insurance eligibility and benefits via phone, payer portals, and clearinghouses.
• Contact insurance companies to confirm coverage, co-pays, deductibles, co-insurance, and out-of-pocket maximums.
• Determine prior authorization and referral requirements.
• Document verification details accurately in the hospital's electronic health record (EHR) system.
• Communicate coverage details and financial responsibility to patients when applicable.
• Collaborate with scheduling, registration, billing, and clinical departments to resolve discrepancies.
• Identify coverage limitations and escalate complex cases as needed.
• Maintain productivity and quality standards in a fast-paced call center environment.
• Ensure compliance with HIPAA and hospital privacy policies.
• Assist with denial prevention by ensuring accurate pre-service verification.

Qualifications

• High school diploma or equivalent (Associate degree preferred).
• 1-3 years of experience in insurance verification, patient access, medical billing, or healthcare call center environment.
• Strong knowledge of commercial insurance, Medicare, Medicaid, and managed care plans.
• Experience working with EHR/EMR systems and insurance portals.
• Excellent verbal communication and customer service skills.
• Strong attention to detail and accuracy.
• Ability to multitask and manage high call volumes.
• Proficiency in Microsoft Office and basic data entry.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

* As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities.

Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.