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Benefits Verification Representative Jobs (NOW HIRING)

UHS

Insurance Verification Representative-PT

Houston, TX · On-site

$15.25 - $19.75/hr

Responsibilities Insurance Verification Representative Opportunity West Oaks Hospital has provided ... Other job duties as assigned Benefit Highlights: * Challenging and rewarding work environment

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Benefits Verification Representative information

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How much do benefits verification representative jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for benefits verification representative in the United States is $19.53, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $20.91 per hour, depending on experience, location, and employer.

What is a benefits verification representative?

Benefits Verification Representatives are professionals who help patients, healthcare providers, or pharmacies determine and confirm patients’ insurance coverage for medical treatments, procedures, or medications. They contact insurance companies to verify what benefits are available, explain coverage details, and identify any out-of-pocket costs or pre-authorization requirements. Their work ensures that patients receive care smoothly and understand their financial responsibilities before services are provided.

What are the key skills and qualifications needed to thrive as a benefits verification representative, and why are they important?

To thrive as a Benefits Verification Representative, you need a solid understanding of health insurance processes, medical terminology, and data entry, often supported by a high school diploma or equivalent. Familiarity with benefits verification software, healthcare databases, and CRM systems is typically required. Strong attention to detail, problem-solving abilities, and effective communication help you excel when interacting with patients, providers, and insurance companies. These skills are essential to ensure accurate benefit verification, prevent costly errors, and provide timely support to patients navigating their insurance coverage.

What are some common challenges benefits verification representatives face and how can they overcome them?

Benefits Verification Representatives often encounter challenges such as navigating complex insurance policies, managing high call volumes, and dealing with frequent policy updates. To overcome these, it helps to stay organized, maintain up-to-date knowledge of insurance procedures, and communicate clearly with both patients and insurance companies. Building strong relationships with colleagues in billing and clinical teams can also streamline the verification process and help resolve issues quickly.

What is the difference between Benefits Verification Representative vs Insurance Claims Specialist?

AspectBenefits Verification RepresentativeInsurance Claims Specialist
CredentialsHigh school diploma or equivalent; some roles may require certification in healthcare or insuranceHigh school diploma; certifications like CPC or CCA may be preferred
Work EnvironmentHealthcare offices, hospitals, insurance companiesInsurance companies, healthcare facilities, claims processing centers
Job FocusVerifying patient benefits, insurance coverage, and eligibilityProcessing, reviewing, and adjudicating insurance claims
Common UsageHealthcare and insurance industriesInsurance industry, healthcare providers

The Benefits Verification Representative primarily focuses on confirming patient insurance coverage and eligibility, ensuring smooth billing processes. In contrast, the Insurance Claims Specialist handles the processing and resolution of insurance claims after services are provided. Both roles require knowledge of insurance policies and strong attention to detail, but they differ in their specific responsibilities within the healthcare and insurance sectors.

More about Benefits Verification Representative jobs

What states have the most Benefits Verification Representative jobs?

States with the most job openings for Benefits Verification Representative jobs include:

What are popular job titles related to Benefits Verification Representative jobs?

For Benefits Verification Representative jobs, the most frequently searched job titles are:

Benefits Verification Representative jobs near you
Infographic showing various Benefits Verification Representative job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, and 5% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution, with an average salary of $40,625 per year, or $19.5 per hour.

Insurance Verification Representative- Onsite

Farragut, TN • On-site

Community Health Systems
See more jobs at Community Health Systemsexternal

$15 - $19/hr

Other

This job post has expired today. Applications are no longer accepted.

Community Health Systems rating

6.9

Company rating: 6.9 out of 10

Based on 276 frontline employees who took The Breakroom Quiz

Job description

Insurance Verification Representative

The Insurance Verification Representative is responsible for accurately verifying patient insurance coverage, benefits, and eligibility to ensure proper reimbursement and prevent service delays. This role coordinates with physician offices, case management teams, and financial counseling to facilitate pre-certifications, authorizations, and patient financial obligations. The Insurance Verification Representative plays a key role in maintaining accurate patient account liability, minimizing denials, and improving revenue cycle efficiency.

Essential Functions

  • Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients, ensuring accuracy and completeness before services are rendered.
  • Coordinates with physician offices to obtain required pre-authorizations and pre-certifications, preventing reschedules or cancellations due to missing approvals.
  • Confirms patient coverage for procedures and treatments, documenting insurance details, policy limitations, and reimbursement expectations.
  • Initiates financial counseling for uninsured or underinsured patients, referring them to financial assistance programs or payment plan options.
  • Accurately documents and updates patient records, including pre-certification numbers, eligibility details, and authorization statuses.
  • Communicates effectively with patients and physician offices, providing clear information regarding insurance coverage, financial responsibilities, and payment expectations.
  • Ensures timely entry of pre-registration documents into the electronic health record (EHR) and forwards them to the appropriate department.
  • Maintains accurate department records, reports, and documentation, ensuring compliance with billing, regulatory, and facility policies.
  • Identifies and resolves insurance discrepancies, proactively addressing issues that could result in billing errors or claim denials.
  • Works collaboratively with case management, patient registration, and billing teams, ensuring seamless revenue cycle operations and optimized reimbursement.
  • Performs other duties as assigned.
  • Maintains regular and reliable attendance.
  • Complies with all policies and standards.

Qualifications

  • 0-2 years of experience in insurance verification, medical billing, or patient access in a healthcare setting required
  • 2-4 years of insurance verification experience in an acute care hospital or physician practice group preferred
  • Experience with electronic health records (EHR), insurance portals, and revenue cycle workflows preferred

Knowledge, Skills and Abilities

  • Strong knowledge of insurance verification, pre-authorizations, and patient financial services.
  • Proficiency in healthcare insurance terminology, including co-pays, deductibles, out-of-pocket costs, and covered services.
  • Ability to interpret and apply insurance policies and payer guidelines to verify eligibility and benefits accurately.
  • Effective communication and customer service skills, ensuring professional interactions with patients, physician offices, and insurance providers.
  • Strong organizational and time-management skills, handling multiple verification requests efficiently.
  • Proficiency in electronic health record (EHR) systems, payer websites, and insurance portals for eligibility verification.
  • Understanding of HIPAA regulations and patient privacy requirements when handling sensitive financial and insurance information.

Licenses and Certifications

  • CHAA - Certified Healthcare Access Associate preferred

Job Identification 162901

Job Category Finance and Accounting

Locations 10820 Parkside Dr, Knoxville, TN, 37934, US

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