Healthcare Insurance Verifications Specialist

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Position Overview:
An Insurance Verifications Specialist is responsible for ensuring the accuracy and completeness of healthcare insurance information for patients or clients. This role involves verifying insurance coverage, confirming if prior authorizations are needed or not, and working closely with insurance companies.

Pocket Overview:
Pocket provides a cheaper and faster insurance verification process for physical therapists.
We know that insurance verification is painful and can take up to 1-2 hours to verify a patient's insurance coverage, potentially delaying appointment scheduling and care.
Pocket will take on the pain of dealing with insurance so front desk staff can focus on customer-facing interactions and PTs can focus on what they do best – treating patients.

Key Responsibilities:
1. Healthcare Insurance Verification:
Confirm patient eligibility and insurance coverage by contacting insurance carriers via phone.
Responsible for effective and efficient verification of all patients’ benefits before their appointment.
Verify benefits for physical therapy services.
Ensure accurate documentation of coverage details, including co-pays, deductibles, out-of-pocket expenses, authorization requirements and visit limits.
2. Authorizations:
Confirm if authorization is needed or not
If it’s needed, confirm what is required to submit authorization
3. Data Entry and Record Maintenance:
Accurately input insurance details into our internal database or client’s EMR platform.
Update patient accounts with the latest insurance information and maintain confidentiality in compliance with HIPAA regulations.
Record calls using online recording software (provided by Pocket)
4. Customer and Team Support:
Serve as a point of contact for physical therapy admin staff with questions about their insurance coverage or billing.
5. Problem-Solving:
Identify and address insurance coverage issues or errors proactively.
Follow up with insurance companies if there is conflicting information.

Qualifications and Skills:
1. Experience:
2+ years of experience in insurance verification, medical billing, or a related field.
Familiarity with U.S. based insurance plans, benefits, and medical terminology.

2. Technical Skills:
Proficiency in using EMR systems, insurance portals, Google Suite (Google Docs, Google Sheets) and Microsoft Office Suite.
Strong data entry skills with high attention to detail.
3. Interpersonal Skills:
Excellent written / verbal communication and customer service skills.
Ability to work collaboratively in a team-oriented environment.
4. Problem-Solving: Analytical skills to resolve coverage discrepancies
5. Security:
Must adhere to all HIPAA guidelines and regulations.
Maintain patient and company confidentiality.

Work Environment:
Remote
Must be able to work weekdays 9am - 5pm Eastern Time Zone
Must have reliable internet connection and use their personal computer
Requires heavy interaction with insurers via phone

This role is ideal for individuals who thrive in a detail-oriented, fast-paced environment and have a passion for supporting healthcare processes.

Interview Process:
1) Assessment with Voice Recording
2) Live Testing
3) Behavioral Interview