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Insurance Verification Specialist

ActivStyle -
Saint Paul, MN

Quick Apply

Job Details

$18 - $21 an hour
5 days ago

Benefits

Paid holidays
Health insurance
Dental insurance
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Opportunities for advancement

Qualifications

Customer communication
High school diploma or GED

Full Job Description

Insurance Verification Specialist

Work Arrangement: Remote

About This Opportunity

Ready to make a real difference in people's lives? ActivStyle is seeking compassionate, detail-oriented individuals to join our team, where purpose meets professionalism. As a trusted provider of home-delivered medical supplies, we empower our clients to live with dignity, independence, and comfort.

As an Insurance Verification Specialist, you'll play a critical part in ensuring our patients receive the essential products and services they need. In this role, you'll obtain, analyze, and verify referral and insurance information accurately and efficiently. You'll work closely with patients, healthcare providers, and insurance companies to support timely billing, clean claim processing, and seamless product delivery.

Your attention to detail and commitment to exceptional service will directly impact our patients' experience and access to care. If you're passionate about helping others, enjoy solving problems, and thrive in a supportive, mission-driven environment, we'd love to welcome you to the ActivStyle family.

Why You'll Love Working at ActivStyle

Meaningful work that positively impacts patients' lives every day
Supportive and collaborative team culture
Opportunities for professional growth and development
Mission-driven organization focused on care, dignity, and service

Position Summary

Insurance Verification Specialists are responsible for understanding the entire front-end process to ensure successful service for our patients. You will obtain, analyze, and verify the accuracy of information received from referrals, verify insurance to ensure clean claim processing, and ensure timely billing and delivery of products as ordered by physicians. You will educate patients about their financial responsibility when applicable and guide them through the insurance verification process.

Essential Functions and Job Responsibilities

Develop and maintain working knowledge of current products and services offered by the company
Review all required documentation to ensure accuracy
Maintain extensive knowledge of different types of payer coverage and insurance policies
Verify patient insurance coverage to ensure necessary procedures are covered by the individual's insurance accurately
Complete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductibles
Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required
Resolve any issues with coverage and escalate complicated issues to a manager
Complete accurate patient demographic and insurance entry into EMR databases
Enter data accurately into EMR databases, including payer, authorization requirements, coverage limitations, and expiration dates as needed
Spend extensive amounts of time on the phone or on payer websites with insurance companies
Provide pertinent information regarding patient's coverage to relevant parties
Navigate through multiple online EMR systems to obtain applicable documentation
Communicate with Customer Service and Management on an ongoing basis regarding any noticed trends with insurance companies
Verify insurance carriers are listed in the company's database system; if not, request that new carriers be entered
Contact patients when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process
Meet quality assurance requirements and other key performance metrics
Pay attention to detail and maintain great organizational skills
Remain flexible with work tasks and hours of operation
Utilize company-provided tools to maintain quality, including Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (Medicare Provider Enrollment, Chain, and Ownership System), and "How-To" documents
Assume on-call responsibilities during non-business hours in accordance with company policy
Maintain patient confidentiality and function within HIPAA guidelines
Complete assigned compliance training and other educational programs as required
Participate in educational programs as required
Perform other related duties as assigned

Competencies, Skills, and Abilities

Excellent customer service skills
Analytical and problem-solving skills with attention to detail
Strong decision-making abilities
Excellent ability to communicate both verbally and in writing
Ability to prioritize and manage multiple tasks
Proficient computer skills and knowledge of Microsoft Office
Solid ability to learn new technologies and possess the technical aptitude required to understand data flow through systems and system interaction
General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred
Work well independently and as part of a team
Ability to adapt and remain flexible in a rapidly changing environment; be patient, accountable, proactive, take initiative, and work effectively on a team
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form

Education and Experience Requirements

High School Diploma or equivalent
One (1) year of work-related experience in healthcare administrative, financial, or insurance customer services, claims, billing, call center, or management regardless of industry
Exact job experience is considered any of the above tasks in a Medicare-certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance

Physical Demands and Work Environment

Work environment may be stressful at times, as overall office activities and work levels fluctuate
Must be able to bend, stoop, stretch, stand, and sit for extended periods of time
Subject to long periods of sitting and exposure to computer screens
Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use
Must be able to lift 5 to 10 pounds periodically as needed
May be exposed to angry or irate customers or patients
Excellent ability to effectively communicate both verbally and in writing with customers, demonstrating empathy, compassion, courtesy, and respect for privacy
Mental alertness to perform the essential functions of the position

Amazing Benefits At A Glance

Team-driven and values-based culture
Medical, Dental, and Vision Benefits
Paid Time Off (PTO), Holiday Pay, Sick and Safe Time for Applicable States
Employee Assistance Program
Career Growth Opportunities
401(k) and Generous Employer Match Opportunity
Starting wage: $18 - $21/hour based on experience

Our Commitment to Diversity and Inclusion

At ActivStyle, we don't just accept difference—we celebrate it, we support it, and we thrive on it for the benefit of our team and our community. We are proud to be an equal opportunity workplace and an affirmative action employer.

E-Verify Notice

This employer participates in E-Verify. Following acceptance of any job offer, at the start of employment, the employer will provide the federal government Form I-9 information to confirm that you are authorized to work in the U.S. If E-Verify is unable to verify your eligibility for employment, this employer will provide written instructions to give you an opportunity to contact the appropriate agencies and resolve the discrepancy prior to taking any action against continued employment.

Ready to Join Our Team?

Join us and be part of a team dedicated to making healthcare more accessible, one patient at a time. Apply today to become an Insurance Verification Specialist at ActivStyle!

Quick Apply

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Explore jobs in more locations

Insurance Verification Specialist

About This Opportunity

Why You'll Love Working at ActivStyle

Position Summary

Essential Functions and Job Responsibilities

Competencies, Skills, and Abilities

Education and Experience Requirements

Physical Demands and Work Environment

Amazing Benefits At A Glance

Our Commitment to Diversity and Inclusion

E-Verify Notice

Ready to Join Our Team?