Insurance Verification Specialist
Company:FamilyWell
Location:USA
Languages:English
Seniority level:Middle, 2-3 years
Experience:2-3 years
Skills:
Project ManagementSQLBusiness AnalysisData AnalysisMicrosoft ExcelDocumentationMicrosoft Office SuiteAttention to detailOrganizational skillsTime ManagementWritten communicationMultitaskingComplianceJSONQuality AssuranceFinanceScriptingDebuggingChange ManagementCustomer SuccessConfluenceEnglish communicationBookkeepingSaaSBudget managementPowerPointInterpersonal skillsRelationship buildingProblem-solving skillsTeamworkResearchFluency in EnglishNegotiation skillsReportingTroubleshootingWritingActive listeningStrong work ethicAbility to learnClient relationship managementBudgetingStrong communication skillsCross-functional collaborationData entryRelationship managementAnalytical thinkingData analyticsData managementCustomer support
Requirements:
High school diploma or GED required; Associate's or Bachelor's degree in health administration, business, healthcare management or related field preferred. Minimum 2-3 years of experience in healthcare provider services, prior authorization, utilization management, provider access or RCM in a multi-payer environment. Strong working knowledge of insurance eligibility, authorizations, CPT/HCPCS codes, payer policies (especially behavioral health/CoCM), and EMR/authorization workflow systems. Experience with payer types including Medicaid MCOs, FFS, Medicare Advantage and commercial insurers. Experience working in a behavioral health or women’s health setting is a strong plus. Excellent organizational, time-management and documentation skills. Strong communication skills. Detail-oriented and proactive. Analytical mindset. Ability to translate technical payer policy/authorization requirements into clear internal SOPs and patient-facing communications. Comfort working in a remote environment and collaborating across teams.
Responsibilities:
Verify patient insurance eligibility and behavioral health benefits. Confirm coverage for therapy, psychiatry, coaching, and Collaborative Care (CoCM) codes. Determine plan type and in/out-of-network status. Identify high-deductible plans and flag accounts for patient cost-share counseling. Verify secondary insurance. Enter accurate benefit details in Healthie. Ensure benefit information is complete and documented prior to appointment. Maintain internal benefit verification logs. Communicate coverage issues to patients. Collaborate with billing, credentialing, and patient collections teams. Work with OB/GYN partner clinics to confirm referral details and PA requirements. Escalate benefit discrepancies or payer issues to RCM leadership. Maintain high accuracy in insurance verifications. Stay current on payer updates and plan changes. Protect patient information in compliance with HIPAA.
