About this role
Seeking a detail-oriented and organized Insurance Verification & Precertification Coordinator to join our team. This position is responsible for both insurance verification and precertification activities, with approximately half of the role dedicated to each function. The ideal candidate will ensure patients' insurance coverage, eligibility, and authorization requirements are accurately verified while helping patients understand their financial responsibilities. This role works closely with insurance providers, patients, clinical teams, and administrative staff to support efficient operations and minimize delays in patient care.
Duties
- Verifying patient insurance eligibility, coverage, and benefits for office visits, procedures, surgeries, and injectable services.
- Obtaining required insurance authorizations and precertifications, including submitting supporting medical documentation.
- Preparing and providing surgical and injectable estimates to patients.
- Communicating patient financial responsibilities, insurance benefits, and coverage limitations.
- Documenting insurance verification and precertification status, authorization details, and patient financial responsibility in the appropriate systems.
- Coordinating with insurance companies, patients, front office staff, and clinical teams to resolve insurance-related issues and prevent delays in patient care.
- Confirming eligible appointments and ensuring all necessary documentation is uploaded to the patient's chart.
- Supporting efficient clinic operations and helping ensure timely reimbursement for services rendered.
Qualifications
Qualifications
- High school diploma or equivalent required.
- Previous experience in a healthcare or insurance-related role preferred.
- Associate degree in healthcare administration or a related field preferred.
- Familiarity with medical terminology and insurance coding.
- Experience working with electronic medical record (EMR) systems.
- Strong attention to detail and accuracy in data entry and documentation.
- Excellent verbal and written communication skills.
- Ability to communicate professionally and effectively with patients, insurance representatives, and team members.
- Basic computer skills, operational knowledge, and good typing skills.
- Ability to apply common sense and problem-solving skills when handling insurance-related issues.
- Strong organizational, planning, multitasking, and prioritization skills.
- Ability to work efficiently under pressure and manage competing deadlines.
- Pleasant and professional telephone manner with a strong commitment to customer service.
- Spanish-speaking ability is beneficial.
- No certifications or licenses required.