About this role
As an Insurance Verification Representative at Physicians Regional Medical Center you'll join a team and be a part of a culture that's dedicated to providing top quality care to our patients. Our full-time employees enjoy a robust benefits package which may include health insurance, 401(k), licensure/certification reimbursement, and student loan assistance for eligible roles.
Job Summary
The Insurance Verification Representative is responsible for verifying insurance coverage and benefits for scheduled procedures and services. This role ensures accuracy in patient records and assists in obtaining prior authorizations, if needed, to facilitate timely reimbursement. The Insurance Verification Representative works closely with clinical and administrative teams to provide a seamless patient experience.
Essential Functions
- Verifies patient insurance information, including eligibility, benefits, and coverage limitations.
- Reviews scheduled services and procedures to determine any necessary pre-certifications or authorizations.
- Coordinates with insurance providers to obtain required authorizations and verifies prior approvals.
- Communicates insurance requirements and benefit information to patients and answers any questions related to coverage.
- Accurately enters and updates insurance information in the patient’s medical record and billing systems.
- Identifies and resolves any insurance-related discrepancies or issues, working with other departments as necessary.
- Assists with resolving denied authorizations and facilitates appeals as required.
- Performs other duties as assigned.
- Maintains regular and reliable attendance.
- Complies with all policies and standards.
Qualifications
- 0-2 years of experience in insurance verification, billing, or a related role in a healthcare setting required
Knowledge, Skills and Abilities
- Basic knowledge of insurance terminology, eligibility verification, and authorization processes.
- Strong attention to detail and accuracy in data entry and documentation.
- Effective communication and interpersonal skills for interacting with patients, staff, and insurance companies.
- Ability to manage time effectively and work in a fast-paced environment.
- Proficient in basic computer skills and comfortable navigating healthcare billing or insurance software.
This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for an employer.
Other facts
About Community Health Systems
Community Health Systems is one of the nation’s leading healthcare providers. Developing and operating healthcare delivery systems across 14 states, CHS is committed to helping people get well and live healthier. CHS affiliates operate 70 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.
What you'll do
- The Insurance Verification Representative is responsible for verifying insurance coverage and benefits for scheduled procedures and services. This role ensures accuracy in patient records and assists in obtaining prior authorizations to facilitate timely reimbursement.
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