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Insurance/ Verification Specialist

Insurance/ Verification Specialist

Eligibility - Nc
Job Locations 
Employment Type 
Regular Full-Time
Position Schedule 

More information about this job

Position Summary


WESTMED Practice Partners is currently seeking a Eligibility Specialist to join the team. The ideal candidate will have experience in determining and processing medical eligibility for our patients.  Ensuring patient information and eligibility have been accurately verified and recorded in our Practice Management database.  A passion for providing exceptional customer service to all of our clients, internal and external is essential for consideration. WESTMED Practice Partners Eligibility Department is a centralized service, we serve as Subject Matter Experts for our internal customers providing information and assistance regarding difficult insurance inquiries. Bilingual skills preferred, (Spanish/English)

Essential Job Functions & Responsibilities

  • Ensuring insurance verification is validated with the appropriate insurance carrier employing multiple methods such as electronic submissions to our clearinghouse, manual submissions processed through insurance websites, and/or by telephone.
  • Verifying medical coverage prior to scheduled appointments and ensuring that certain preventive and specialty benefits are thoroughly reviewed. 
  • Notifying our patients of any insurance issues and resolving prior to their scheduled appointment.
  • Completing assigned special projects as needed these can include but are not limited to research projects pertaining to insurance company benefit guidelines and requirements.

Required Qualifications

  • Maintain a positive and encouraging behavior by adhering to the company’s Success Profile: Confidence, Integrity, Pride and Passion.
  • High School Diploma or equivalent, Associates Degree preferred
  • Strong interpersonal skills
  • Exceptional communication and customer service skills
  • Working knowledge of insurance verification and medical office procedures
  • Strong time management skills, the ability to plan, prioritize and complete delegated tasks within the expected time line
  • Microsoft Office Experience
  • Ability to adapt to changing workflows, processes and work queues
  • Ability to support team, departmental and organizational protocols, workflows, policies and procedures