About the Role
The impact you will make
You will build a foundational knowledge of insurance requirements and assist in resolving eligibility issues that impact claims reimbursement. This role ensures that missed or secondary insurance coverages are pursued for payment to optimize reimbursement and reduce patient liability. The representative collaborates closely with payers, patients, and internal teams to resolve account discrepancies and complete the billing cycle efficiently and compliantly.
What you will do
Major Responsibilities/Activities:
• Learn and navigate the Insurance Discover platform and Hospital Patient Account Systems
• Work assigned insurance eligibility accounts and assist in resolving issues related to coverage, coordination of advantages, and patient information
• Contact insurance companies to verify active coverage, eligibility dates, and policy details
• Identify and document reasons for eligibility denials (e.g., inactive coverage, COB, incorrect payer)
• Load or Correct insurance information in client systems and resubmit claims when applicable
• Collaborate with team members to ensure accurate and timely resolution
• Use appropriate status codes and follow-up indicators in the system
• Escalate complex or recurring issues to senior staff
• Prepare basic payer correspondence or appeals when needed
• Maintain compliance with HIPAA and internal policies
• Obtain and maintain offsite access to patient accounting systems (PAS)
• Complete all mandatory PAS training
• Upkeep process documentation, as assigned.
• Meet productivity and quality standards as established by the department.
What you will bring
• Fresher or 1 + years of experience in healthcare, insurance verification, or related field
• Basic understanding of health insurance types (Medicare, Medicaid, Commercial)
• Willingness to learn eligibility requirements and COB rules
• Excellent attention to detail, time management, organizational and communication skills.
• Comfort using payer