Insurance Verification Specialist

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $45k - $60k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔒 Insurance

🚫👨‍🎓 No degree required

👻 Ghost score 2%

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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Blue Water Thinking

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

📦 Logistics

🛡️ Insurance

Healthcare • Logistics • Insurance

Blue Water Thinking is a Service Disabled Veteran Owned Small Business (SDVOSB) certified by the Department of Veterans Affairs. The company provides strategy, management, and technology solutions tailored for government agencies. Blue Water Thinking focuses on the healthcare sector, offering health program support, health analytics, and health assessments to improve outcomes for military personnel and veterans. Additionally, the company aids federal agencies in digital transformation, enabling them to harness data and technology to enhance services. Its management advisory services aim to enhance decision-making, transparency, and performance across government programs. Inspired by deep thinking and value innovation, Blue Water Thinking delivers agile, custom solutions to support fiscal stewardship in public sector initiatives.

📋 Description

• Verify patient insurance coverage through automated databases, direct patient contacts, and communication with insurance companies. • Verify insurance benefits, policy numbers, pre-certification requirements, eligibility, and effective coverage dates. • Complete work through standardized controls, including batched work, caseload levels, and defined workflows. • Perform Medicare and commercial insurance reimbursable billing activities. • Identify billable cases and ensure bills are generated accurately and on time. • Validate claims, confirm patient eligibility, and refer questionable or potentially inaccurate coding for review. • Review insurance and billing information for discrepancies, missing information, or reimbursement issues. • Follow established timeliness, objective, priority, and workload requirements. • Assess the appropriateness and accuracy of claims data. • Communicate with internal staff and stakeholders to resolve billing, insurance, eligibility, and claim discrepancies. • Use office software, electronic databases, and healthcare information systems to document, process, track, and manage activities. • Maintain complete documentation according to VA, VHA, contractual, and organizational requirements. • Protect sensitive patient and insurance information and follow privacy, security, and information-handling requirements. • Support Department of Veterans Affairs clients, including the Veterans Health Administration.

🎯 Requirements

• High School Diploma or equivalent. • Two years of experience in insurance verification, medical billing, healthcare revenue cycle, patient financial services, claims processing, or a related healthcare administrative function. • Demonstrated experience verifying insurance eligibility, benefits, coverage dates, policy information, and authorization or pre-certification requirements. • Experience working with Medicare and/or commercial health insurance claims and reimbursement processes. • Proficiency with Microsoft Office applications, electronic databases, and other office or healthcare information systems. • Strong attention to detail with the ability to accurately review claims, insurance information, and billing documentation while meeting established deadlines. • Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future. • Must be able to obtain and maintain the required federal public trust clearance for this role. • Preferred: Experience supporting the Department of Veterans Affairs, Veterans Health Administration, or other federal healthcare programs. • Preferred: Experience with VHA or VA healthcare administrative, billing, eligibility, or revenue cycle processes. • Preferred: Familiarity with Medicare, commercial insurance, third-party billing, and healthcare reimbursement requirements. • Preferred: Knowledge of medical terminology, insurance terminology, claims processing, and healthcare revenue cycle workflows. • Preferred: Experience working with electronic health records, patient management systems, insurance verification platforms, or medical billing applications. • Preferred: Familiarity with claim validation, coding review processes, eligibility verification, and identifying billable services. • Preferred: Strong written and verbal communication skills with the ability to collaborate effectively with clinical, administrative, billing, and insurance personnel. • Preferred: Ability to manage multiple priorities, meet production and quality requirements, and work effectively within standardized workflows. • Preferred: Experience handling sensitive patient information in accordance with applicable privacy and security requirements. • Resume must be submitted in Word document format and include dates in each section.

🏖️ Benefits

• Health insurance (medical, dental and vision) • Paid time off • Federal holidays • Matching 401K plan