Insurance Verification Specialist

Overview

HealthPRO Heritage has a great Insurance Verification Specialist opportunity!

This is a fully remote position supporting our services teams across the United States, working typically Eastern Time Zone hours, with compensation of $18–$22 per hour. In this role, you’ll help ensure accurate insurance eligibility and benefits information so families and clinic teams have a seamless experience from scheduling through billing.

Why Choose HealthPRO Heritage?

• Purpose-Driven Work: Be part of a mission-driven organization dedicated to compassionate care and innovative healthcare solutions for children and families.
• Remote Flexibility: Enjoy the convenience of working remotely while collaborating with a supportive team across our pediatric services.
• Growth Opportunities: Take advantage of opportunities to learn, develop new skills, and grow your career within a healthcare organization.
• Collaborative Culture: Thrive in a supportive environment where teamwork, respect, and open communication are at the heart of everything we do.
• Commitment to Excellence: Join a team committed to delivering high-quality services and creating positive experiences for the patients and families we serve.
• Competitive Total Rewards: We offer competitive compensation and a comprehensive Total Rewards package designed to support your professional and personal well-being. Eligible employees may have access to benefits including medical, dental, and vision coverage; retirement savings opportunities; paid time off; employee assistance resources; and additional voluntary benefits, based on eligibility and employment status.

Join Us in Making a Difference

At HealthPRO Heritage, we offer meaningful career opportunities where your work directly supports the care and services provided to children and families. As a therapist-led, diverse organization, we provide clinical services across a variety of settings, including nursing facilities, retirement communities, hospitals, home care, and pediatric schools and clinics. Join a team that values your skills, supports your development, and gives you the opportunity to make a meaningful difference in the communities we serve.

Responsibilities

• Verify Insurance Eligibility & Benefits: Verify patient insurance coverage, eligibility, benefits, exclusions, deductibles, co-insurance, and prior authorization requirements.
• Maintain Accurate Insurance Information: Review and update insurance and billing information to ensure records are complete, accurate, and current.
• Track Insurance Verifications: Maintain accurate tracking of completed, pending, and outstanding insurance verifications and follow up as needed.
• Support Scheduling & Patient Access: Provide timely and accurate eligibility and benefit information to parents, clinic staff, and other internal teams to help prevent delays in scheduling and patient care.
• Identify & Resolve Issues: Identify discrepancies, coverage limitations, denied claims, and other payer-related issues and take appropriate steps to obtain missing information or resolve discrepancies.
• Support Billing & Collections: Assist the billing team with benefit verification, claim-related questions, co-insurance, private-pay balances, and other insurance-related billing issues.
• Review Billing Documentation: Review billing and insurance documentation for completeness and accuracy and ensure required forms and supporting information are obtained and maintained.
• Manage Denied Claims: Identify claims denied due to insurance coverage or eligibility issues, obtain necessary documentation, and track follow-up through resolution.
• Maintain Patient Records: Ensure insurance and billing documentation is accurately maintained in the appropriate systems and patient records.
• Data Entry & Reporting: Enter required insurance and billing information into designated systems and prepare accurate reports and documentation for management.
• Cross-Functional Communication: Collaborate with therapists, clinic leaders, billing teams, and other internal stakeholders to address insurance and billing issues and ensure timely resolution.
• Professional Customer Communication: Communicate professionally with parents, patients, and other responsible parties regarding insurance benefits, billing questions, balances, and required documentation.

Qualifications

Required Qualifications

• High school diploma or GED equivalent.
• Strong attention to detail and accuracy.
• Excellent professional communication skills, both verbal and written.
• Ability to meet deadlines, prioritize responsibilities, and manage multiple tasks efficiently.

Preferred Qualifications

• Associate degree or coursework in Healthcare Administration, Medical Billing & Coding, Health Information Management, Business Administration, or a related field.
• Previous experience with insurance verification, healthcare billing, claims, or revenue cycle operations, with a basic understanding of payer requirements and processes.
• Experience handling sensitive and confidential patient or billing information with professionalism and discretion.
• Ability to clearly communicate and resolve insurance, billing, and account-related issues with patients, families, and internal teams.
• Proficiency with Microsoft Word and Excel.
• Experience working with electronic medical records (EMR), billing, or healthcare information systems is a plus.

HealthPRO Heritage and its subsidiaries provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, HealthPRO Heritage and its subsidiaries comply with applicable state and local laws governing nondiscrimination in employment in every location in which the company facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.