Insurance Verification Specialist

Job Description - Insurance Verification & Benefit SpecialistClassification - FSLA - Non-Exempt - hourlySalary Grade/Level/RangeLevel of experience, longevity, within current company pay structure.Reports to Revenue Cycle ManagerSummary/ObjectiveThe insurance verification & benefit specialist is responsible for obtaining and verifying accurate insurance information, benefit validation, referrals and preservice collections.Essential FunctionsCollects and documents all required demographic and financial patient data.Analyzes patient insurance(s), identifies the correct insurance plan, selects appropriate plan from practice management software and documents the correct insurance order.Collects insurance referrals and documents in the practice management software.Screens visits for medical necessity and issues Advance Beneficiary or Non-Covered Service notices as appropriate.Provides cost estimates.Obtains information from the patient if third party payers need to be billed (ie/workers compensation, auto insurance, etc)Screens all patient self-pay & out of network patients and provides the appropriate cost estimates.Provides information for follow-up and referral to the financial counselor as appropriate for outstanding balances. Verifies participating status of providers.Assists in educating and acts as a resource to appointment call center department.Works and assists with the billing department in researching and resolving rejected, incorrectly paid, and denied claims as requested.Responds professionally to all inquiries from patients, staff, and payors in a timely manner.Qualities and CharacteristicsMaintains a professional relationship and positive attitude with co-workers, patients and all M.I.N.D staff.Strives to learn more and receptive to new challenges and opportunities.Displays enthusiasm toward the work and the mission of M.I.N.D. QualificationsHigh School Diploma or GED.Demonstrated knowledge of insurances1+ year experience in insurance verification, including navigating websites for online benefit review.Knowledge of CPT and ICD-10 codes.Excellent computer, multi-tasking and phone skills.The ability to work well under pressure (most of the paperwork is time sensitive).Must successfully pass a background check and drug screen.Work EnvironmentThis job operates in a medical office facility. Physical DemandsThis position requires the ability to sit for long periods of time, view computer screens for long period of time, answering calls on a multi-line phone system, writing, reading and note taking. Position Type/Expected Hours of WorkThis is a full-time position. Days and hours of work are Monday through Friday, varying hours between 8:00 a.m. to 4:30 p.m. Travel - noneOther DutiesPlease note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employees should adhere to all approved policies, procedures and philosophies.

Created: 2026-04-02