Insurance Verification

We’re looking for a sharp, detail-obsessed Eligibility & Insurance Verification Rep who knows insurance like it’s second nature. If you’ve spent at least three years navigating Medicare, Medicaid, and all the wild flavors of commercial plans, this role is your turf. You’ll make sure every patient scheduled across our five service locations is fully verified, fully cleared, and fully ready for their appointment—no surprises, no drama.

Key Responsibilities

• Review and verify insurance eligibility 2–3 days before patient appointments across all service locations.
• Confirm active coverage, benefits, and referral requirements using Phreesia, eCW EMR, and insurance portals.
• Update patient insurance details and referral information directly in Phreesia and eCW.
• Contact patients via phone, email, or text to collect missing or updated information.
• Communicate with PCP offices to request or follow up on referrals when required.
• Coordinate with FCRS office staff regarding any unresolved or missing insurance information.
• Contact insurance companies directly to verify eligibility, benefits, claims details, payer IDs, and billing addresses.
• Utilize insurance portals—such as Cigna for HCP, CareFirst, Availity, and UHC—including basic search and payer chat functions.
• Enter detailed and accurate notes into eCW and Phreesia for reference by front desk and billing teams.
• Review past appointments to ensure all required insurance information was captured and properly documented.
• Handle daily verification requests from office staff, especially for plans that cannot be verified electronically.
• Add or update new patient accounts for Hospital Rounding Charges.
• Reach out to patients to correct outdated contact details (address, phone, email).
  
  

Required Experience & Skills

• 3 years of hands-on insurance verification experience, including:
• Medicare, Medicare Advantage, and Medicare Secondary
• Medicare Secondary MSP codes
• Medicaid vs. Medicaid Advantage
• Commercial plans: HMO, PPO, POS, Open Access
• Strong understanding of referral requirements and insurance-specific guidelines.
• Proficiency with eCW EMR, Phreesia, and major insurance portals.
• Excellent verbal and written communication skills for interacting with patients, insurance reps, and office staff.
• High accuracy, strong attention to detail, and the ability to multitask across multiple service locations.
  

Work-from-Home Device Requirement

• Device: Personal computer with Intel Core i5 or higher, or AMD Ryzen 5 or higher
• Internet: Wired connection with at least 50 Mbps download speed, plus a backup connection (e.g., mobile hotspot or prepaid Wi-Fi)
• Work Environment: Quiet, well-lit space with minimal background noise
  
  

Benefits

• Permanent Work From Home
• Weekly Paychecks
• Fixed Weekends Off
• HMO Reimbursement on your 90th day
• Thriving Company Culture with Complete Autonomy
• Exclusive Specialized Training Programs
• Unlock Your Potential with a Highly Competitive Salary
  
  

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Who are we?

MedCore Solutions is the healthcare division of BizForce, dedicated to supporting U.S.-based healthcare clients through a skilled remote workforce in the Philippines. We specialize in connecting top clinical and administrative talent with reputable healthcare organizations, ensuring high-quality care delivery while providing rewarding work-from-home careers.

Why work for Bizforce?

Bizforce is a global remote workforce solutions company currently partnering with some of the largest Architectural and Engineering firms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today! Bizforce was founded with one goal – to deliver dependable high-quality skilled labor and business processes to US-based companies at affordable prices. Bizforce has grown rapidly and allows the best talent in PH to work remotely from home with the latest technology and resources. BizForce is proud to partner with PH to deliver qualified, professional workers, giving our Architects and Engineers the ability to have an unbeatable career and work from home.