Insurance Coverage Specialist

1 week ago

Barcelona, Philippines beBeeInsuranc Full time ₱50,000 - ₱76,000

Job Title: Insurance Coverage Specialist

Job Overview:

We are seeking a highly skilled and detail-oriented Insurance Coverage Specialist to join our team. This role plays a critical part in supporting healthcare providers, treatment centers, and billing departments by verifying patients' insurance coverage and benefits.

The ideal candidate will have a strong understanding of medical terminology, insurance procedures, and excellent communication skills. They will work remotely to contact insurance companies, gather necessary coverage details, document findings, and communicate with relevant internal teams.

Key Responsibilities:
  1. Verify Patient Insurance Benefits
  • Contact insurance companies by phone or via portals to verify patient coverage and eligibility.
  • Gather detailed information on covered services, copays, deductibles, and prior authorization requirements.
  • Accurately document all benefit details in the EHR or billing system.
Submit Authorization Requests
  • Prepare and submit prior authorization requests, including relevant clinical documentation.
  • Follow up on pending authorizations with insurance carriers to ensure timely approvals.
  • Maintain accurate records of all submitted authorizations.
Track Authorization Expiry and Renewals
  • Monitor and track expiration dates for existing authorizations.
  • Proactively initiate renewal processes prior to expiration to avoid service disruptions.
  • Notify the clinical and administrative teams of any issues or lapses.
Coordinate with Clinical Staff
  • Request and compile necessary clinical documentation for submissions.
  • Communicate with clinicians to ensure all required documents are up to date and compliant.
  • Ensure Compliance and Accuracy
  • Maintain confidentiality and comply with HIPAA and internal data protection policies.
  • Ensure accurate data entry, documentation, and reporting of insurance verification and authorization status.
Required Skills and Qualifications:
  • At least 2 years of proven experience in medical billing, insurance verification, or healthcare administration.
  • Strong knowledge of insurance terminology and benefit structures.
  • Excellent verbal and written communication skills.
  • Detail-oriented with the ability to multitask and manage time effectively.
  • Proficient in using spreadsheets, CRM tools, and insurance portals.
  • Reliable internet connection and a quiet, professional remote work environment.
What We Offer:

This role offers a unique opportunity to make a real difference in the lives of patients and healthcare providers. If you are passionate about delivering exceptional customer service and have a keen eye for detail, we encourage you to apply.

We are committed to providing a supportive and inclusive work environment that fosters growth and development. Our team is dedicated to making a positive impact in the community, and we are looking for like-minded individuals to join us.

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