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Insurance Verification Associate Jobs in Pennsylvania

Ohio Health

Office Specialist

Lancaster, PA · On-site

$16.63 - $24.15/hr

Confirm patient demographic information Verify insurance Provide great Customer Service Collect Co ... OhioHealth does not discriminate against associates or applicants because of race, color, genetic ...

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Insurance Verification Associate information

How do you become an insurance verification specialist?

To become an insurance verification specialist, candidates typically need a high school diploma or equivalent and should develop skills in insurance billing, coding, and customer service. Relevant certifications, such as the Certified Insurance Verifier credential, can enhance job prospects, and familiarity with electronic health record systems is often required.

What are the key skills and qualifications needed to thrive as an Insurance Verification Associate, and why are they important?

To thrive as an Insurance Verification Associate, you need strong attention to detail, knowledge of insurance policies and procedures, and typically a high school diploma or equivalent. Familiarity with insurance verification software, electronic health records (EHR) systems, and claims management tools is highly valuable. Excellent communication, problem-solving skills, and the ability to handle confidential information with discretion set top performers apart. These skills ensure accurate processing of patient insurance information, minimize billing errors, and support timely reimbursement for healthcare services.

What is the difference between Insurance Verification Associate vs Medical Billing Specialist?

AspectInsurance Verification AssociateMedical Billing Specialist
Primary RoleVerify patient insurance coverage and benefits before servicesProcess and submit medical claims for reimbursement
CredentialsHigh school diploma or equivalent; certifications like Certified Medical Administrative Assistant (CMAA) are commonHigh school diploma; certifications like Certified Professional Biller (CPB) are common
Work EnvironmentHealthcare offices, hospitals, clinicsMedical offices, billing companies, healthcare facilities
Industry UsageUsed across healthcare providers to ensure insurance coverageUsed to handle claims processing and reimbursement

The Insurance Verification Associate focuses on confirming patient insurance details to ensure coverage before treatment, while the Medical Billing Specialist handles the claims process for reimbursement. Both roles require similar certifications and work in healthcare settings, but their core responsibilities differ in the patient verification versus billing process.

What is the highest paid position in insurance?

In the insurance industry, executive roles such as Chief Executive Officer (CEO), Chief Underwriting Officer, and Chief Financial Officer (CFO) tend to be the highest paid. These positions require extensive experience, leadership skills, and often advanced certifications, and they oversee company strategy, underwriting, and financial management.

What does a verification associate do?

An Insurance Verification Associate reviews and confirms patients' insurance coverage and benefits to ensure accurate billing and claims processing. They typically communicate with insurance companies, verify policy details using specialized software, and maintain accurate records to support the healthcare or insurance team. Attention to detail and knowledge of insurance policies are essential for this role.

Is it hard to learn insurance verification?

Insurance Verification Associates typically learn the job through on-the-job training, and the process involves understanding insurance policies, billing procedures, and using verification tools or software. While some familiarity with healthcare or insurance terminology helps, the role generally does not require extensive prior experience and can be learned with practice and training.

What does an Insurance Verification Associate do?

An Insurance Verification Associate is responsible for confirming a patient's insurance coverage and benefits before medical services are provided. Their tasks include contacting insurance companies, verifying policy details, determining coverage limits, and ensuring that procedures are authorized. This role helps prevent billing issues and ensures that patients and providers understand what costs will be covered. Insurance Verification Associates play a crucial part in the healthcare revenue cycle by reducing claim denials and improving the patient experience.

What are some common challenges faced by Insurance Verification Associates, and how can they be overcome?

Insurance Verification Associates often encounter challenges such as navigating complex insurance policies, handling discrepancies in patient information, and managing high call volumes with insurance companies. To overcome these, associates should develop strong attention to detail, effective communication skills, and proficiency with insurance databases and electronic health record systems. Staying organized and keeping up-to-date with insurance policy changes also helps ensure accurate and timely verification, which ultimately supports smooth patient billing and care processes.
What are the most commonly searched types of Insurance Verification jobs in Pennsylvania? The most popular types of Insurance Verification jobs in Pennsylvania are:
What are popular job titles related to Insurance Verification Associate jobs in Pennsylvania? For Insurance Verification Associate jobs in Pennsylvania, the most frequently searched job titles are:
What job categories do people searching Insurance Verification Associate jobs in Pennsylvania look for? The top searched job categories for Insurance Verification Associate jobs in Pennsylvania are:
What cities in Pennsylvania are hiring for Insurance Verification Associate jobs? Cities in Pennsylvania with the most Insurance Verification Associate job openings:
Insurance Verification Associate jobs near you
Authorization Specialist

Authorization Specialist

Lehigh Valley Health Network

Allentown, PA • On-site

$17.75 - $23.75/hr

Full-time

Medical

Posted 5 days ago

Lehigh Valley Health Network rating

7.1

Company rating: 7.1 out of 10

Based on 273 frontline employees who took The Breakroom Quiz

377th of 884 rated healthcare providers

Job description

Imagine a career at one of the nation's most advanced health networks.
Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work.
LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day.
Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network.
Summary
Obtains benefits and authorizations for surgical procedures, diagnostic testing, medications, outgoing referrals, and other services as part of daily operations. Determines the authorization protocols for each health plan and performs billing duties to ensure proper and timely payment is received from insurance carriers and patients.
Job Duties
  • Collaborates with physicians and provider office staff in ascertaining the appropriate authorization based on medical necessity and the treatment plan provided.
  • Performs a medical necessity check to determine if procedure and diagnosis support medical necessity.
  • Ensures authorizations are obtained in accordance to network policy (any authorization not falling into policy guidelines is communicated to ordering office, patient, and manager).
  • Communicates direct/indirect with insurance companies to obtain insurance verification, benefits and precertification for approval.
  • Verifies additional clinical information and insurance authorizations/referrals.
  • Reviews and monitors WQs/schedules to ensure that proper and accurate authorization has been received prior to patient's visit.
  • Maintains compliance with benchmark data regarding accounts registered versus scheduled procedures.
  • Determines estimated patient financial responsibility using insurance verification information and payer contracts and/or self-pay guidelines.

Minimum Qualifications
  • High School Diploma/GED with specialized training in insurance, coding, billing, or similar healthcare certificate programs.
  • 1 year in a healthcare setting with insurance verification/authorizations.
  • Familiarity with billing procedures and payer reimbursement.
  • Knowledge of patient rights and laws relative to those rights, such as HIPAA.
  • Proficient in utilization management processes, standards, and managed care.
  • Proficient in standard medical practices and insurance benefit structures.

Preferred Qualifications
  • Associate's Degree

Physical Demands
Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.
Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.
Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities.
https://youtu.be/GD67a9hIXUY
Lehigh Valley Health Network does not accept unsolicited agency resumes. Agencies should not forward resumes to our job aliases, our employees or any other organization location. Lehigh Valley Health Network is not responsible for any agency fees related to unsolicited resumes.
Work Shift:
Day Shift
Address:
1259 S Cedar Crest Blvd
Primary Location:
Allentown- 1259 Cedar Crest
Position Type:
Onsite
Union:
Not Applicable
Work Schedule:
Monday-Friday 8am-4:30pm
Department:
1012-90102 LVPG-L Adult & Pediatric Psych - 1259 S Cedar Crest

What Lehigh Valley Health Network employees say

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Hours and flexibility

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About Lehigh Valley Health Network

Sourced by ZipRecruiter

LVHN is one of the nation's most advanced health networks, offering comprehensive care in 95 clinical specialties. We are the region's largest employer and the health care provider of choice for more people in the region. Love Where You Work!

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Allentown, PA, US

Year founded

1899

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