Insurance Verification Specialist

Overview

Job Title:

Insurance Verification Specialist.

Reports To:

Phone Room Manager.

Job Location:

Wilmington, DE 19803. Hours/Week: 40.

• Verify patient insurance eligibility, benefits, and coverage details prior to appointments, including copays, deductibles, referrals, and authorization requirements.
• Contact insurance carriers via phone or online portals to confirm active coverage and obtain necessary information.
• Accurately document verification details in the practice management system.
• Identify and communicate any coverage issues, discrepancies, or authorization requirements to appropriate staff and/or patients.
• Collect, enter, and update patient demographic and insurance information with a high degree of accuracy.
• Assist patients in understanding their insurance coverage, financial responsibilities, and referral requirements when applicable.
• Triage incoming calls and route them appropriately to clinical or administrative staff.
• Collaborate with front desk, billing, and clinical teams to resolve insurance-related issues.
• Maintain compliance with HIPAA and all applicable privacy regulations.
• Provide exceptional customer service in all patient interactions.

• Job Knowledge and Skills
• Strong understanding of insurance verification processes, including eligibility checks, benefits, referrals, and prior authorizations.
• Familiarity with commercial insurance plans, Medicare, Medicaid, and managed care plans preferred.
• Proficiency in Microsoft Office (Word, Outlook, Excel) and practice management systems.
• Experience using insurance portals and verification tools is highly desirable.
• Excellent attention to detail and strong organizational skills.
• Effective communication skills, with the ability to explain insurance information clearly to patients.
• Ability to multitask in a fast-paced environment while maintaining accuracy.
• Working knowledge of medical terminology preferred.
• Reliable, self-motivated, and able to work both independently and as part of a team.
• Must consistently monitor and respond to email communications in a timely manner.

• Education
• High School Diploma or GED required; additional healthcare or administrative training is a plus.

• Experience
• Prior experience in insurance verification, medical front office, or healthcare revenue cycle preferred.
• Experience in an orthopaedic or specialty practice is a plus but not required.

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location:

In person