What are the responsibilities and job description for the Insurance Verification Representative - Pecos Valley Family Clinic position at Eastern New Mexico Medical Center?
Why Join Us?
Hours of Operation: Monday-Thursday 8am-5pm Friday 8am-12pm
Job Summary
The Insurance Verification Representative is responsible for verifying insurance coverage and benefits for scheduled procedures and services. This role ensures accuracy in patient records and assists in obtaining prior authorizations, if needed, to facilitate timely reimbursement. The Insurance Verification Representative works closely with clinical and administrative teams to provide a seamless patient experience.
Essential Functions
- Be Valued for What You Bring to the Team – Competitive pay that rewards your hard work
- Benefits You Can Count On – Medical, dental, vision, and life insurance coverage
- Work Hard. Recharge Often. – Generous PTO and extended illness benefits
- Invest in Your Future – 401(k) with company match
- Grow With Us – Career development, learning opportunities, and advancement pathways
- We Invest in Your Success – Licensure and certification reimbursement for eligible roles
- Student Loan Support – Assistance available for eligible roles
- Your Wins Deserve Recognition – Employee rewards and recognition programs
- A Team You'll Love Working With – A collaborative, purpose-driven culture making a difference every day
- Additional Voluntary Benefits – Choose from options such as pet insurance, identity protection, and legal insurance.
Hours of Operation: Monday-Thursday 8am-5pm Friday 8am-12pm
Job Summary
The Insurance Verification Representative is responsible for verifying insurance coverage and benefits for scheduled procedures and services. This role ensures accuracy in patient records and assists in obtaining prior authorizations, if needed, to facilitate timely reimbursement. The Insurance Verification Representative works closely with clinical and administrative teams to provide a seamless patient experience.
Essential Functions
- Verifies patient insurance information, including eligibility, benefits, and coverage limitations.
- Reviews scheduled services and procedures to determine any necessary pre-certifications or authorizations.
- Coordinates with insurance providers to obtain required authorizations and verifies prior approvals.
- Communicates insurance requirements and benefit information to patients and answers any questions related to coverage.
- Accurately enters and updates insurance information in the patient’s medical record and billing systems.
- Identifies and resolves any insurance-related discrepancies or issues, working with other departments as necessary.
- Assists with resolving denied authorizations and facilitates appeals as required.
- Performs other duties as assigned.
- Maintains regular and reliable attendance.
- Complies with all policies and standards.
- 0-2 years of experience in insurance verification, billing, or a related role in a healthcare setting required
- Basic knowledge of insurance terminology, eligibility verification, and authorization processes.
- Strong attention to detail and accuracy in data entry and documentation.
- Effective communication and interpersonal skills for interacting with patients, staff, and insurance companies.
- Ability to manage time effectively and work in a fast-paced environment.
- Proficient in basic computer skills and comfortable navigating healthcare billing or insurance software.