Job Description

Job Title:                       Insurance Verification Specialist

Reports To:                        Patient Access Manager

Job Summary:                     Assists revenue cycle process by verifying patient eligibility prior to date of service based on information on patient’s charts and appointments scheduled.


Essential Job Duties:

The job duties and responsibilities listed below are representative of the knowledge, skill, and/or ability required.  Other duties that fall within the broad scope of this classification may be assigned.

  • Reviews, verifies, and confirms patient insurance coverage and eligibility prior to time of service.
  • Works with internal practice management software and verifies insurance information via external web portals.
  • Follows up with patients to obtain any needed or missing insurance or patient information.
  • Obtains required information from patients and explains basic insurance benefits, deductibles, and copays.
  • Verifies and updates patient demographic information via electronic health record, verbally and/or patient portal.
  • Reviews available insurance resources and refers patients as needed for assistance in obtaining insurance.
  • Assists CCHCI staff with insurance inquiries as requested.


Minimum Qualifications - Education, Experience, Certificates & Licenses:

  • High School Diploma or GED required.
  • At least one year customer service telephone-based experience required.
  • At least one year computer experience required.
  • Any equivalent combination of education and/or relevant experience that provides the necessary skills may be considered.
  • Valid Fingerprint Clearance Card required.


Preferred Qualifications:

  • At least one year of experience in a healthcare setting providing office support preferred.
  • Experience with medical insurance verification process preferred.  
  • Knowledge of health plans and community health centers preferred.


Other Required Knowledge, Skills, and Abilities:

  • Ability to communicate effectively both verbally and in writing.
  • Ability to gather data in an organized fashion from varied sources.
  • Ability to perform a variety of assignments and make decisions requiring independent judgment.
  • Ability to foresee and address challenges involving one or more variables in routine situations.
  • Ability to function effectively in a fast-paced environment and provide excellent customer service via telephone, mail, and in-person.
  • Ability to prioritize and plan work activities, use time efficiently, meet deadlines and work independently.

Required Language Skills:

  • Ability to comprehend and compose instructions, correspondence, and communications in English in both oral and written format.
  • Bilingual in Spanish and English preferred.


Physical Requirements:

  • Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
  • Ability to continuously remain in a stationary position.
  • Ability to occasionally move about inside the workplace to access files, office machinery, etc.
  • Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
  • Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
  • Ability to discern the nature of sounds at a normal spoken volume.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.


Work Environment & Conditions:

  • Work environment is typical of an administrative office setting with no substantial exposure to adverse environmental conditions.