Medical Insurance Verification Agent – U.S. Healthcare

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iSTA Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

📦 Logistics

📣 Marketing

Healthcare • Logistics • Marketing

iSTA Solutions is your remote healthcare operations partner specializing in off-site staffing solutions. With over 20 years of experience, we focus on enhancing operational efficiency for businesses, particularly in the healthcare sector, by providing customized remote teams that take on tasks ranging from customer service to data entry. Our goal is to support organizations in scaling their operations seamlessly while achieving significant cost savings and improved productivity.

📋 Description

• Verify patient insurance eligibility and benefits using U.S. insurance portals • Confirm active insurance coverage and identify relevant benefits and coverage information • Capture and document verified insurance information accurately • Upload supporting documentation to patient records • Manage approximately 10–15 Verification of Benefits (VOBs) per day • Identify and communicate discrepancies or issues with insurance coverage • Retrieve and download medical records from the patient management system • Prepare utilization review packets for insurance providers • Submit authorization requests by email, fax, or telephone according to payer requirements • Follow up with insurance companies on pending authorization requests • Monitor authorization expiry dates and request extensions when required • Maintain records of authorization requests, follow-ups, and outcomes • Own each request from submission through response and approval • Obtain approvals within required timeframes to prevent delays in patient care

🎯 Requirements

• Previous experience within U.S. healthcare or U.S. medical insurance is essential • Excellent English communication skills, including conversational fluency, comprehension, and professional written communication • Previous experience with insurance verification, eligibility, benefits, authorizations, or pre-authorizations • Experience working with U.S. insurance portals and payer processes • Experience handling confidential medical and patient information • Previous Verification of Benefits (VOB) experience • Experience with Utilization Review (UR) • Experience obtaining or following up on insurance authorizations • Experience in behavioural health, substance use treatment, ABA, or another U.S. healthcare environment • Familiarity with U.S. commercial insurance and/or managed care • Mandatory fixed fibre internet connection at the remote work location with at least 25 Mbps upload and download speeds; Rain, LTE, 5G, or similar connections are not acceptable • Mandatory reliable backup power solution supporting equipment for the duration of scheduled working hours during outages • Availability Monday to Friday, 8:00 AM–5:00 PM EST / 2:00 PM–11:00 PM SAST, subject to daylight saving changes • Availability to work all South African public holidays

🏖️ Benefits

• Compensation for working South African public holidays in accordance with the Basic Conditions of Employment Act (BCEA) • Fully remote work arrangement