Top 20155 Insurance Verification Representative Jobs

Member Service Representative
Champion Health Plan/ Champion Payer Solutions —Long Beach, CA
- From $22 an hour
- Weekends as needed
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Senior Insurance Authorization Specialist
Ensemble RCM LLC —Richmond, VA
- From $18.65 an hour
- Full-time
- Hospital
- Mid-level
- High school diploma or GED
- Tuition reimbursement
Insurance Verification and Eligibility Specialist
Olympic Sports & Spine —Tacoma, WA
- $20.00 - $31.81 an hour
- Full-time
- Customer service
- Mid-level
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3d
Customer Service Representative
QUIPT HOME MEDICAL INC —Wilder, KY
- Microsoft Excel
- High school diploma or GED
- Typing
- Paid holidays
- Disability insurance
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Medical Insurance Verification Specialist
Evolve Chiropractic —Schaumburg, IL
- $16 - $18 an hour
- Full-time
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- US work authorization
- Data entry
- Health insurance
- Dental insurance
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Insurance Verification Representative - Work From Home : Must work in EST 8a-5p Monday - Friday
Prism Medical Products, LLC —Melbourne, FL
- Full-time
- Remote
- Mid-level
- Mentoring
- Commercial
- Paid holidays
- Health insurance
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REMOTE - Call Center Representative
Ivy Hall —Remote
- $18 - $20 an hour
- Weekends as needed
- Remote
- Bilingual
- Ability to sit for extended periods
- Communication skills
- Health savings account
- Paid holidays
Quick Apply
12d
Call Center & Insurance Verification Representative
PARK WEST HEALTH SYSTEMS INCORPORATED —Baltimore, MD
- $18 an hour
- Full-time
- High school diploma or GED
- 1 year
- Entry level
Quick Apply
Authorization Representative
Therapeutic Associates Physical Therapy —Remote
- $17 - $20 an hour
- Full-time
- Remote
- Customer service
- Medical office experience
- Physical & Rehabilitation Medicine
- Profit sharing
- Wellness program
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12d
Insurance Verification Specialist
Kennedy Krieger Institute —Baltimore, MD
- $40,043.12 - $66,204.53 a year
- Full-time
- Mid-level
- High school diploma or GED
- 1 year
Insurance Verification Specialist (Benefit Specialist)
Valeris —Jeffersonville, IN
- Bilingual
- Background check
- Computer literacy
- Health savings account
- AD&D insurance
Quick Apply
Insurance Verification Representative - Remote (Tri-County Area)
University of Miami —Medley, FL
- Full-time
- Remote
- Bilingual
- Computer literacy
- Mid-level
- Health insurance
- Dental insurance
Insurance Verification Representative
Signature Healthcare —West Bridgewater, MA
- $20 - $24 an hour
- Full-time
- Office
- High school diploma or GED
- Communication skills
Quick Apply
Insurance Verification Representative
AHS Vista LLC —Waukegan, IL
- $22 - $28 an hour
- Full-time
- High school diploma or GED
- 1 year
- Entry level
- Dental insurance
- 401(k)
Quick Apply
Insurance Authorization Specialist II
SYSTEM West Virginia University Health System —Remote
- Full-time
- Remote
- Microsoft Outlook
- Computer literacy
- Basic math
Scheduling and Prior Authorization Representative- Remote
McKenzie Health —Watford City, ND
- Weekends as needed
- Remote
- Background check
- Word processing
- Computer literacy
- 403(b) matching
- Employee assistance program
Quick Apply
12d
Insurance Verification Representative
Novir —Milwaukee, WI
- Seasonal
- Customer service
- Medical office experience
- HIPAA
Quick Apply
14d
Remote Healthcare Call Center Representative
Conduent Commercial Solutions, LLC —Remote
- $16.50 an hour
- Weekends as needed
- Remote
- Background check
- High school diploma or GED
- Typing
- Paid training
- Paid holidays
5d
Customer Service Representative
Firstsource Healthcare —Remote
- $15 an hour
- 8 hour shift
- Remote
- Computer literacy
- Writing skills
- Typing
- Dental insurance
- Work from home
Referral Coordinator/ Insurance Verification Representative
MedVein Management, LLC —San Antonio, TX
- Monday to Friday
- Computer literacy
- Basic math
- HIPAA
Quick Apply

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Member Service Representative

Champion Health Plan/ Champion Payer Solutions
Long Beach, CA

Quick Apply

Job Details

Full-time
From $22 an hour

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Flexible schedule

Qualifications

Spanish
Customer communication
Teamwork
Customer retention
Managed care
Managed care organization experience
Call center experience
HIPAA
English
Vietnamese
High school diploma or GED
Medical terminology

Full Job Description

SCOPE OF ROLE

The Member Service Representative (MSR) serves as the first point of contact for customers, providers, and advocates, ensuring exceptional customer experiences through accurate and helpful communication. This role involves handling incoming calls from Medicare Advantage members, assisting with benefit inquiries, referrals, claims, and guiding them to community resources as needed. The ideal candidate will be bilingual, proficient in medical terminology, and knowledgeable in CMS, Medicare, and HIPAA regulations. Strong proficiency in Microsoft Applications and a commitment to delivering top-tier service are essential.

ROLE RESPONSIBILITIES

The Member Service Representative job description is intended to point out major responsibilities within the role, but it is not limited to these functions:

KEY RESPONSIBILITIES % OF TIME

 Serve as the primary point of contact for customers, providers, and advocates, handling calls with professionalism and courtesy.

 Provide clear, concise, and accurate information to ensure customers fully understand their benefits, referrals, claims, and available resources.

 Ensure prompt and efficient service by answering all incoming calls within the

department’s established time frame.

 Escalate complex issues to management or relevant departments as necessary to

ensure customer concerns are thoroughly addressed.

 Collaborate with internal teams to resolve problems and enhance overall customer

satisfaction.

 Accurately document customer interactions, including actions taken, resolutions

provided, and any follow-up required.

 Adhere to department policies and HIPAA regulations to maintain confidentiality and

security of member information.

 Manage complaints, grievances, and appeals efficiently according to department

protocols.

 Assist in onboarding and training new staff, sharing knowledge and best practices.

 Complete required training promptly to stay current with procedures, systems, and

regulations.

 Consistently meet or exceed standards for quality, productivity, and adherence to

schedules.

 Participate in outbound call campaigns for welcome calls, enrollment verification calls, appointment scheduling,

retention efforts, and other health-related programs.

 Contribute to policy and procedure development related to customer experience.

 Stay updated on CMS, Medicare, and HIPAA regulations to ensure compliance and

provide accurate information.

 Utilize medical terminology and healthcare knowledge to assist members with inquiries.

 Adapt to changes in shifts, responsibilities, and operational needs as required.

 Facilitate member requests for provider changes, transportation, and other assistance.

 Maintain a positive attitude and practice excellent customer service principles.

 Perform other duties as assigned to contribute to the team and department’s success

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

 High School diploma or GED required.

 Associate degree (AA) degree (preferred).

 Minimum (2) or more years of direct customer service EXPERIENCE

 Knowledge of Medi-Cal, Medicare Managed Care Plans.

 Medical front office experience preferred.

PROFESSIONAL COMPETENCIES

 Strong communication skills (verbal and written).

 Highly organized with the ability to prioritize work to meet deadlines.

 Strong adaptability and openness to change.

 Knowledge of HIPAA regulations with a commitment to data privacy.

 Strategic skills in problem-solving, critical thinking, and innovation.

 Ability to collaborate effectively with business partners throughout the organization.

 Experience assisting members with Medicare Advantage or HMO, including referrals and authorizations.

 Outbound/inbound call center experience with a focus on problem-solving and escalation.

 Bilingual in English/Spanish or Vietnamese/English required.

 Proficiency in Microsoft Applications (Word, Excel, Outlook).

 Ability to multitask and prioritize tasks effectively.

 Flexibility to work varying shifts, including evenings and weekends.

LICENSURES AND CERTIFICATIONS

No licensures or certifications are required.

WORK ENVIRONMENT and ESSENTIAL PHYSICAL FUNCITONS:

Work Environment:

 Must be available for scheduling 7 days a week, including evenings, overnights, weekends, and holidays.

 Shifts may change based on operational needs; flexibility is essential.

Essential Physical Functions:

 Ability to work onsite in an open office setting, primarily sitting at a desk and working on a computer.

 Regularly required to talk, hear, stand, walk, sit, and use hands to handle or feel objects and controls.

 Frequently lifts/moves up to 10 pounds. Specific vision abilities include close vision and the ability to adjust focus.

EEO/AFFIRMATIVE ACTION STATEMENT

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse group of employees committed to meeting the needs of Champion Payer Solutions/ Champion Health Plan, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Job Type: Full-time

Pay: From $22.00 per hour

Benefits:

401(k)
Dental insurance
Flexible schedule
Health insurance
Paid time off
Vision insurance

Experience:

Managed care: 2 years (Required)

Language:

Spanish (Preferred)
Vietnamese (Preferred)

Ability to Commute:

Long Beach, CA 90815 (Required)

Ability to Relocate:

Long Beach, CA 90815: Relocate before starting work (Preferred)

Work Location: In person

Quick Apply

Refine Your Search

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I want to receive the latest job alert for Insurance Verification Representative

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