Insurance Verification Representative

5 hours ago
Full-time
Junior
Operations
Vail Health

Vail Health

Vail Health, formerly Vail Valley Medical Center, is a nonprofit community health care system providing a wide range of services including hospital care, orthopaedics, cardiology, physical therapy, cancer treatment, childbirth, and surgery. With a focu...

Health Care Providers & Services
501-1000
Founded 1965

Description

  • Verify patient insurance eligibility and benefits before scheduled appointments using online systems, phone communication, and other resources.
  • Assign accurate payer plan codes in the electronic health record system.
  • Verify medical necessity under CMS standards and communicate coverage and eligibility details to patients.
  • Gather missing demographic, insurance, and pre-authorization information from patients, clinicians, physician offices, front-end staff, and translators.
  • Determine primary and secondary payer liability and coordinate benefits.
  • Obtain required pre-certifications and pre-authorizations from third-party payers.
  • Escalate complex verification or eligibility issues and notify patients or physician offices of impacts.
  • Communicate patient financial responsibility and coordinate payment or financial-assistance discussions.
  • Maintain HIPAA compliance and uphold Just Culture principles.

Requirements

  • Ability to work a standard 8:00 AM–4:30 PM MST schedule regardless of location.
  • Must live and work primarily in AZ, CO, CT, FL, GA, ID, IL, KS, MA, MD, MI, MN, NC, NJ, OH, OR, PA, SC, TN, TX, UT, VA, WA, or WI for remote-based roles.
  • One year of customer service experience preferred.
  • Insurance verification or healthcare experience preferred.
  • At least one year of professional Epic experience, including verification of Physical Therapy and/or Occupational Therapy workflows, strongly preferred.
  • Degree in healthcare administration or a related field preferred.

Benefits

  • Hourly pay of $20.30–$24.19 based on relevant education and experience.
  • Medical, dental, and vision insurance.
  • Up to five weeks of paid time off in the first year, increasing with tenure.
  • Four weeks of paid parental leave, housing programs, and childcare reimbursement.
  • Tuition assistance, student loan repayment, certification reimbursement, and annual education funds.
  • 403(b) retirement plan with immediate matching, life insurance, and short- and long-term disability coverage.
  • Up to $1,000 annual wellbeing reimbursement, recreation discounts, and pet insurance.

Interested in this position?

Apply directly on the company website

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