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Insurance Verification Representative
Vail Health. Verify patient insurance eligibility and benefits before scheduled appointments .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in patient insurance verification, including eligibility and benefits assessment, while ensuring compliance with HIPAA and CMS standards. Proficient in using Epic for managing healthcare workflows and communicating effectively with patients and healthcare professionals.
Highest-signal resume keywords
Insurance VerificationEpic ProficiencyHIPAA ComplianceCustomer Service ExperienceHealthcare Administration Degree
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Patient Insurance Eligibility VerificationPayer Plan Code AssignmentMedical Necessity VerificationPre-Certification and Pre-AuthorizationElectronic Health Record Management
Soft Skills
Effective CommunicationProblem-SolvingCollaboration
Industry Keywords
Just Culture PrinciplesCMS StandardsHealthcare ExperienceFinancial Responsibility CoordinationDemographic Information Gathering
About the role
Key responsibilities & impact- Verify patient insurance eligibility and benefits before scheduled appointments
- Use online systems, phone communication, and other resources in accordance with Vail Health timelines
- Assign payer plan codes in the electronic health record system
- Verify medical necessity according to CMS standards
- Communicate coverage and eligibility details to patients
- Gather additional information from patients, physicians, clinicians, front-end staff, and translators
- Obtain missing demographic, insurance, and pre-authorization information
- Coordinate primary and secondary payer liability
- Obtain payer pre-certifications and pre-authorizations
- Escalate complex cases and notify patients or physician offices of verification or eligibility issues
- Communicate patient financial responsibility and coordinate payment or financial assistance discussions
- Uphold Just Culture principles and maintain HIPAA compliance
- Perform other duties as assigned
Requirements
What you’ll need- One year of customer service experience preferred
- Insurance verification or healthcare experience preferred
- At least one year of professional experience using Epic, specifically working with and verifying Physical Therapy and/or Occupational Therapy workflows, strongly preferred
- Degree in healthcare administration or a related field preferred
- Must be able to live and work primarily in one of the listed states: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kansas, Massachusetts, Maryland, Michigan, Minnesota, North Carolina, New Jersey, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, or Wisconsin
- Must adhere to the 8:00 AM–4:30 PM MST schedule regardless of location
- Must remain HIPAA compliant
Benefits
Comp & perks- Competitive wages
- Parental leave (4 weeks paid)
- Housing programs
- Childcare reimbursement
- Medical insurance
- Dental insurance
- Vision insurance
- Tuition assistance
- Existing student loan repayment
- Specialty certification reimbursement
- Annual supplemental educational funds
- Up to five weeks paid time off in the first year, increasing each year
- 403(b) retirement plan with immediate matching
- Life insurance
- Short- and long-term disability insurance
- Up to $1,000 annual wellbeing reimbursement
- Recreation discounts
- Pet insurance