INSURANCE VERIFICATION SPECIALIST: Duties, Job Description, and Salaries

INSURANCE VERIFICATION SPECIALIST
INSURANCE VERIFICATION SPECIALIST

A health care professional who works to ensure that a patient’s health care benefits cover necessary procedures is known as an insurance verification specialist. He calls a patient’s insurance company to confirm coverage levels and works with individuals to educate them on their benefits. He is a valuable member of the healthcare team, assisting patients in obtaining necessary medical procedures. An insurance verification specialist can find work in a variety of health care settings, such as hospitals, clinics, and doctor’s offices. In this article, we’ll look at the salary of an insurance verification specialist, as well as the job description and how to find work-from-home opportunities.

Insurance Verification Specialist Salary

The average annual salary for an Insurance Verification Specialist in the United States was $33,781 as of September 2, 2022. In case you need a quick salary calculator, that works out to about $16.24 per hour. This equates to $649 per week or $2,815 per month.

While ZipRecruiter reports annual salaries as high as $42,500 and as low as $20,500, the majority of Insurance Verification Specialist salaries currently range from $30,000 (25th percentile) to $36,000 (75th percentile), with top earners (90th percentile) earning $40,500 across the United States. The average salary range for an Insurance Verification Specialist varies little (around $6,000), implying that there are few opportunities for increased pay or advancement, even with several years of experience, regardless of location.

According to recent ZipRecruiter job postings, the Insurance Verification Specialist job market in New York, NY, and the surrounding area is very active. In your area, an insurance verification specialist earns an average of $36,928 per year, which is $3,147 (9%) more than the national average annual salary of $33,781. Insurance Verification Specialist salaries in New York rank ninth out of fifty states.

What Factors Influence a Salary?

An insurance verification specialist’s salary is determined by a variety of factors, including education, experience, and job location. Also, we will investigate how these factors influence salary.

#1. Years of expertise

Salary increases are generally tied to your experience level. In general, the longer you work as an insurance verification specialist, the more money you can expect to make. According to the Bureau of Labor Statistics and the National Compensation Survey, the following factors can influence your insurance verification specialist’s salary.

#2. Location

The amount you can earn as an insurance verification specialist is also affected by where you live. Working in a large metropolitan area typically equates to a higher salary as well as a higher cost of living.

How to Increase your Insurance Verification Specialist Salary

Let’s look at ways to increase your salary as an insurance verification specialist now that you have a better idea of what you could expect to earn.

#1. Improve your abilities

Pursuing and improving in-demand skills may put you ahead of the competition for promotions and higher-paying jobs. These abilities include:

  • Medical Terminology:  Understand common medical terminology used in insurance paperwork.
  • Insurance Benefits: Learn how various insurance plans cover medical procedures.
  • HIPAA Compliant: Understand how to handle patient information in accordance with HIPAA regulations.
  • Data Entry:   Enter patient information into insurance company databases
  • Customer Service: Answer customer questions about insurance coverage and benefits.

#2. Negotiate your job offer

When you’re offered a job, don’t be afraid to bargain for a higher salary. This is especially important if you are offered a lower-paying job than you expected. Many employers are willing to negotiate, and you may end up with a higher salary than you would have otherwise.

#3. Seek frequent feedback.

Seeking regular feedback from your supervisor is one way to demonstrate your value to your company. This demonstrates that you are enthusiastic about your work and are always looking for ways to improve. Furthermore, regular feedback can assist you in identifying any areas where you may need to improve your skills.

Job Description Insurance Verification Specialist

This Insurance Verification Specialist job description sample can assist you in attracting a creative and experienced Insurance Verification Specialist to your organization. Also, include requirements, benefits, and perks that are specific to the role and your company.

 Job description

Overview: The Insurance Verification Specialists will obtain, clarify, and confirm outpatient benefits, ensuring that the referral source receives maximum and timely payment for services rendered. Also, this individual will provide outstanding customer service to patients/families, health insurance representatives, internal/external providers, clinics, and other institute personnel.

Responsibilities of an Insurance Verification Specialists:

  • Verifies insurance coverage and benefits by using all available verification and eligibility tools, as well as calling payers when necessary. Enters all information gathered into the registration system.
  • Prior to providing services, the payer requires you to verify and/or obtain the necessary referral, authorization, or pre-certification.
  • Obtains patient information in order to facilitate the clinical verification of unique patient identifiers, the billing and collections process, and compliance with state and federal regulatory requirements.
  • After benefits have been determined, estimate self-pay portions (deductibles, co-pays, non-covered services).
  • Documents and follows up on team and clinic awareness efforts.
  • Obtains current demographic information from patients and families.
  • Maintains regular communication and follow-up with patients and families, as well as team leaders, patient accounting, finance, and other departments. Informs all relevant parties about pending referrals, authorizations, unexpected delays, and/or other potential issues.
  • Where applicable, sends supporting documentation to care centers, patient accounting, and clinical areas in a timely manner.
  • Maintains all IAMS Error Logs and the browser in a timely and accurate manner.
  • Responsible for capturing and entering patients’ demographic, financial, and clinical information into various information systems, including pre-registration and/or scanning information systems, in an accurate, complete, and timely manner.

Required Skill Set

A job description for an insurance verification specialist will require prior experience working with insurance companies as well as extensive knowledge of various types of coverage and policies. She must be able to multitask and work on multiple projects at the same time.

To keep accurate patient insurance records, she must be very detail-oriented and organized. It is critical that she be able to focus and work quickly, as insurance paperwork must frequently be processed on time. She must also be able to collaborate with others because she will be working as part of a healthcare team to provide the best possible care to patients.

Secondary Responsibilities

This professional is also a valuable resource for patients, providing them with important information about their coverage. She works with patients to explain insurance coverage amounts so they understand why some procedures are covered while others are not. The insurance verification specialists also assist patients in arranging payment for services that are not covered by their insurance companies, as well as discussing different financing options to fit their budgets. She must also be willing to assist with light administrative tasks as needed.

Qualifications and Requirements

  • High school diploma or GED certificate
  • Bachelor’s degree (or equivalent experience)
  • Experience with medical billing (2 years preferred)
  • Knowledge of CPT codes and basic medical terminology (preferred) (preferred)
  • Phone communication skills
  • Bilingual ability (English/Spanish) is preferred.

What Qualifications do you need to work as Insurance Verification Specialists?

Although this is not a management position, important skills are required to fully execute the role. Customer service and billing; health care administration; JCAHO audit; health insurance verification; and JCAHO Standards Compliance are all required for the role. Medical Practice Management Software is one of the more basic skills required in this role. While these skills are necessary for the job, keep in mind that fitting into the company culture and environment is often just as important.

What is the role of an Insurance Verification specialist?

Insurance Verification Specialists are in charge of pre-verifying insurance for patients who are admitted to the hospital for treatment. Ensures insurance coverage by phone resolves any coverage issues, and escalates complex issues to a supervisor or manager.

Furthermore, Insurance Verification Specialists interviews patients and complete all necessary paperwork to ensure the admitting process runs smoothly and all hospital and regulatory policies are followed. A bachelor’s degree in a specialty field may be required.

Furthermore, insurance verification specialists are usually reported to a supervisor or manager. Typical insurance verification specialists will have 2 to 4 years of related experience. Gained experience with some of the more complex tasks associated with the job function directed in several aspects of the work on occasion.

How to Become Insurance Verification Specialists

Some work-from-home insurance verification specialist jobs require an associate’s degree in medical administration or a related health field, while others may only require a high school diploma and on-the-job training. In these education programs, you will learn the fundamentals of patient privacy law, medical billing, and hospital administrative duties in order to be successful in this career.

Is being an Insurance Verification Specialist Worth it?

Responsible for obtaining appropriate insurance verification, prior approvals, and all authorization requirements prior to the patient’s arrival for surgery, outpatient testing, and observation or in-patient hospitalization.

Insurance Verification Specialist Work From Home

There are numerous online work-from-home insurance verification specialist positions available. All you have to do is take your time and search the internet for offers near you. And carefully choose the one that is best for you.

Here is a list of websites where you can find job listings for work from home insurance verification specialist:

  • Indeed
  • Careers
  • Glassdoor
  • LinkedIn
  • ZipRecruiter

Frequently Asked Questions

Is insurance verification a skill?

Insurance Verification, Health Insurance, Medical Terminology, Healthcare, U.S. Health Insurance Portability and Accountability Act (HIPAA), Medical Billing, Data Entry, and Insurance are some popular Insurance Verification Specialists hard skills.

What are the steps involved in insurance verification?

Procedures for Verifying Health Insurance

  • Patient Scheduling. The patient requests an appointment with the doctor, and the doctor accommodates the request.
  • Enrollment of patients
  • Eligibility and verification 
  • Authorization.
  • Updating patient. 
  • Updating medical billing system. 
  • Claims transmission.

How long does it take to verify insurance?

With a relatively smooth verification process, you could be on the phone for around 20 minutes. As a result, we recommend contacting payers at least 72 hours before a patient’s first visit.

What is an insurance verifier?

An insurance verifier is a hospital or practice employee who specializes in patient claims and the billing process as it relates to claims.

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