Insurance Verification Specialist I - REMOTE

Our Benefits: PTO Paid holidays Employee Incentive Program (ICP) Group Medical, Dental, & Vision Educational Assistance 401(k) Plan Sick Time Life Insurance/Accidental Death and Dismemberment Long-Term and Short Term Disability Medical and Child Care Flexible Spending Accounts Employee Assistance Program (EAP) Job Summary The Insurance Specialist I is responsible for verifying insurance eligibility and benefits, ensuring authorization requirements are met, and completing pre-registration processes for scheduled outpatient and inpatient services. This role ensures compliance with payor guidelines and provides timely and accurate communication with patients, providers, and medical office staff. The Insurance Specialist I supports the financial clearance process by educating patients on insurance benefits and financial responsibilities while maintaining high standards of accuracy and professionalism. Essential Functions: Verifies insurance eligibility and benefits for scheduled and unscheduled services to ensure coverage and compliance with payor requirements. Calculates and communicates the patient’s estimated financial responsibility for scheduled services. Identifies and ensures authorization and referral requirements are met in accordance with payor guidelines. Validates and documents all authorizations and referrals according to established policies. Reviews and determines the medical necessity of scheduled services based on payor criteria. Accurately documents and main