Insurance Verification Specialist
tribe human resources consultingSouth Orange (NJ)
Insurance Verification Specialist
Posted yesterday
tribe human resources consultingSouth Orange (NJ)
SENIORITY
Senior
About the role
Tribe Human Resources Consulting provides specialized HR support and talent solutions to organizations across diverse industries. The firm focuses on aligning people strategies with business goals to help clients build effective, compliant, and inclusive workplaces. Tribe Human Resources Consulting partners closely with clients to understand operational needs and deliver tailored staffing and consulting services. The organization values professionalism, reliability, and strong client relationships, creating opportunities for team members to contribute to high-impact HR and support functions.
Position Summary:
We are seeking a detail-oriented Insurance Verification Specialist to join our team in a full-time remote role. This position is responsible for verifying patient insurance eligibility and benefits, identifying coverage requirements, and ensuring accurate information is documented before services are provided. The specialist will work closely with insurance carriers, patients, providers, billing teams, and internal staff to resolve coverage questions and support efficient healthcare administration.
Key Responsibilities:
Verify patient insurance eligibility, benefits, and coverage prior to scheduled services.
Review deductibles, copayments, coinsurance, coverage limitations, and patient financial responsibilities.
Determine whether referrals or prior authorizations are required and assist with authorization requests.
Contact insurance carriers and payer portals to obtain and confirm benefit information.
Document verification results, authorization status, and payer communications accurately in internal systems.
Identify discrepancies or coverage issues and coordinate appropriate follow-up.
Communicate insurance findings clearly to patients, providers, scheduling teams, and billing personnel.
Maintain accurate and up-to-date patient insurance information.
Follow established procedures for privacy, documentation, and regulatory compliance.
Manage assigned verification requests and follow-ups within required timelines.
Qualifications:
Experience in insurance verification, benefits verification, medical billing, healthcare administration, or a related field.
Working knowledge of health insurance eligibility, benefits, deductibles, copayments, coinsurance, and authorization requirements.
Familiarity with medical terminology and healthcare administrative processes.
Strong attention to detail and accuracy when entering and reviewing information.
Excellent written and verbal communication skills.
Ability to communicate professionally with patients, healthcare providers, and insurance representatives.
Experience using electronic health records (EHR/EMR), payer portals, practice management systems, or similar platforms is preferred.
Familiarity with HIPAA and patient privacy requirements.
Ability to manage multiple requests, follow established procedures, and meet deadlines independently in a remote environment.
High school diploma or equivalent required; additional healthcare, medical billing, or insurance training is a plus.
Compensation and Benefits:
Competitive compensation based on experience and qualifications.
Fully remote work environment.
Professional and collaborative team environment.
Opportunities to develop experience in healthcare administration and insurance operations.
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