Insurance Verification Specialist

🔥 20 hours ago

🇺🇸 United States – Remote

💵 $25 - $31 / hour

⏱ Part Time

🟡 Mid-level

🟠 Senior

🔒 Insurance

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Boston Medical Center (BMC)

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1996

Boston Medical Center (BMC) is a 511-bed, equity-led academic medical center and a proud member of the Boston Medical Center Health System. BMC delivers a model of healthcare where innovative and equitable care empowers all patients to thrive. As a premier academic medical center in Boston, a national leader in clinical care, and the largest essential hospital in New England, BMC’s world-class clinicians provide comprehensive care in more than 70 specialties and subspecialties.

📋 Description

• Screen and process prior-authorization and specialized-services requests for inpatient, outpatient, and ancillary services • Coordinate pre-registration, patient demographics, insurance verification, referrals, authorizations, and precertifications • Prioritize requests and refer those requiring clinical judgment to the appropriate clinician, manager, or medical director • Answer provider and department ACD calls, verify member eligibility, and enter information into CCMS or Facets • Identify network providers, services, and member benefits; communicate authorization decisions • Monitor registration and prior-authorization work queues and obtain required financial-clearance information • Navigate BMC and payer policies to obtain authorizations, precertifications, and referrals • Document referral and prior-authorizations in Epic and link approval numbers to patient appointments • Collaborate with practices, physicians, insurers, patients, case management, and Patient Financial Counseling • Liaise between physicians and payers for peer-to-peer reviews • Escalate denied or financially uncleared accounts according to policy • Interview patients, families, or referring physicians to collect financial, demographic, and insurance information • Reconcile and update demographic, insurance, eligibility, primary-care, subscriber, employer, and appointment information • Maintain confidentiality and comply with healthcare collection laws and regulatory policies • Meet productivity, quality, accuracy, and turnaround-time standards • Participate in training, quality audits, onboarding, and process-improvement initiatives • Report faulty systems or hardware to the appropriate support department and perform other assigned duties

🎯 Requirements

• High school diploma or GED required • 4–5 years of office experience in a high-volume data entry office, customer service call center, healthcare office, or hospital administration • Experience using insurance payer websites, such as Blue Cross Blue Shield and Medicare • Experience with insurance verification, prior authorization, pre-certification, and financial clearance processes • Ability to process high volumes of requests with 95% or greater accuracy • Ability to prioritize workload within specified turnaround timeframes • Thorough knowledge of the financial clearance process, insurance, referral authorizations, and third-party billing procedures • Basic medical terminology and ICD-9/CPT coding knowledge helpful • Epic experience preferred; technical proficiency in Epic work queues and ancillary systems including ADT/Prelude/Grand Centrale • Microsoft Suite proficiency, specifically Excel, Word, Outlook, and Zoom • Ability to maintain strict confidentiality of personal and health-sensitive information • Ability to multitask, manage complex processes, and make independent decisions under pressure • Bilingual preferred • Associate’s degree or higher preferred

🏖️ Benefits

• Medical, dental, vision, and pharmacy benefits • Contract increases • Flexible Spending Accounts • 403(b) savings matches • Earned time cash out • Paid time off • Career advancement opportunities • Resources to support employee and family wellbeing • Educational offerings and development opportunities • Remote work