Insurance Specialist I

About This Role

The Insurance Specialist I verifies insurance eligibility, benefits, and authorization for patient services, ensuring compliance with payor guidelines and supporting the financial clearance process for Community Health Systems.

Responsibilities

• Verify insurance eligibility and benefits for scheduled and unscheduled services
• Calculate and communicate patient's estimated financial responsibility
• Identify and ensure authorization and referral requirements are met
• Validate and document all authorizations and referrals
• Review and determine medical necessity of scheduled services
• Accurately document and maintain all required records and communications
• Communicate effectively and professionally with patients, physicians, and medical office staff
• Educate patients on insurance coverage, benefits, and financial responsibility
• Process and index incoming orders promptly
• Provide timely notification of admission or observation status

Requirements

• Weekend availability
• H.S. Diploma or GED
• 0-1 years of experience in insurance verification, medical billing, or healthcare revenue cycle
• Strong knowledge of insurance plans, authorization requirements, and medical necessity guidelines
• Proficiency in Microsoft Office Suite and healthcare information systems (e.g., EMR, eligibility portals)
• Excellent attention to detail and organizational skills
• Strong communication and interpersonal skills
• Ability to work in a fast-paced environment and manage multiple priorities effectively

Qualifications

• H.S. Diploma or GED
• 0-1 years of experience in insurance verification, medical billing, or healthcare revenue cycle

Skills

* Required skills

Benefits