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Insurance Verification Specialist Jobs in Springfield, MA

Trinity Health

Referral Representative

Hartford, CT · On-site

$17.25 - $22/hr

Contact insurance companies to ensure prior approval requirements are met. * Reviews and updates ... We are a group of primary care providers, specialists and surgeons serving patients in Connecticut ...

Trinity Health

Referral Representative - MA

Hartford, CT · On-site

$17.25 - $22/hr

Contact insurance companies to ensure prior approval requirements are met. * Reviews and updates ... We are a group of primary care providers, specialists and surgeons serving patients in Connecticut ...

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All JobsInsurance Verification Specialist JobsInsurance Verification Specialist Jobs in Springfield, MA

Insurance Verification Specialist information

See Springfield, MA salary details

$12

$18

$26

How much do insurance verification specialist jobs pay per hour?

As of Jul 28, 2026, the average hourly pay for insurance verification specialist in Springfield, MA is $18.80, according to ZipRecruiter salary data. Most workers in this role earn between $16.30 and $20.14 per hour, depending on experience, location, and employer.

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

To thrive as an Insurance Verification Specialist, you need strong attention to detail, knowledge of healthcare insurance processes, and typically a high school diploma or equivalent. Familiarity with electronic health records (EHR) systems, insurance portals, and medical billing software is often required. Excellent communication, organizational, and problem-solving skills help you efficiently coordinate with patients, providers, and insurers. These skills ensure accurate insurance verification, prevent billing errors, and support timely patient care and reimbursement.

What Does an Insurance Verification Specialist Do?

An insurance verification specialist double checks the status of patients’ medical insurance. Their primary responsibility is to ensure that a patient’s insurance will cover required medical procedures or hospital stays. Other duties include verifying patient information, billing, medical coding, and conducting claims examinations. Specialists may also be expected to educate the patient about their coverage.

What jobs make $3,000 a month without a degree?

An Insurance Verification Specialist can earn around $3,000 per month with relevant experience and strong organizational skills, often without requiring a college degree. Other jobs that may pay similar wages without a degree include sales representatives, administrative assistants, and certain skilled trades like HVAC technicians or commercial drivers, depending on experience and certifications. These roles typically rely on on-the-job training, certifications, or technical skills rather than formal degrees.

What are the most common challenges faced by Insurance Verification Specialists, and how can they be managed?

Insurance Verification Specialists often encounter challenges such as navigating complex insurance policies, dealing with frequent changes in coverage, and communicating with both patients and insurance companies to resolve discrepancies. Managing these challenges requires strong organizational skills, attention to detail, and the ability to stay current with industry updates. Building positive relationships with coworkers in billing and patient services departments can also help ensure smoother workflows and accurate verifications.

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

AspectInsurance Verification SpecialistMedical Billing Specialist
Primary RoleVerify patient insurance coverage and benefitsProcess and submit medical claims for reimbursement
CredentialsKnowledge of insurance policies, healthcare regulationsUnderstanding of billing codes, claim submission processes
Work EnvironmentHealthcare facilities, insurance companies, medical officesMedical offices, billing companies, healthcare providers
Common UsagePre-authorization, eligibility checksClaims processing, payment posting

While both roles are essential in healthcare revenue cycle management, the Insurance Verification Specialist focuses on confirming insurance coverage before services are provided, whereas the Medical Billing Specialist handles the claims submission and reimbursement process afterward.

What does an Insurance Verification Specialist do?

An Insurance Verification Specialist is responsible for confirming a patient's health insurance coverage and eligibility before medical services are provided. They contact insurance companies to verify benefits, determine coverage levels, and obtain pre-authorizations if needed. Their work helps ensure that healthcare providers receive proper payment and that patients understand their financial responsibilities. This role requires strong attention to detail, communication skills, and knowledge of healthcare billing processes.

How do you become an insurance verification specialist?

To become an insurance verification specialist, candidates typically need a high school diploma or equivalent, along with strong attention to detail and communication skills. Many employers prefer experience with healthcare billing, insurance processes, or familiarity with electronic health record systems, and some roles may require certification in medical billing or coding. On-the-job training is common, and familiarity with insurance policies and verification tools is beneficial.

What is the role of an insurance verification specialist?

An insurance verification specialist reviews and confirms patients' insurance coverage to ensure that healthcare services are authorized and billed correctly. They gather insurance information, verify eligibility, and communicate with insurance companies to resolve coverage issues, often using specialized software and maintaining attention to detail. This role helps prevent claim denials and ensures smooth billing processes.

What skills do you need to be an insurance verification specialist?

An insurance verification specialist needs strong attention to detail, excellent communication skills, and proficiency with electronic health record systems and insurance databases. Knowledge of insurance policies, coding, and billing procedures is also important, along with the ability to work efficiently in a fast-paced environment. Certifications in medical billing or coding can enhance job prospects.
More about Insurance Verification Specialist jobs
What are popular job titles related to Insurance Verification Specialist jobs in Springfield, MA? For Insurance Verification Specialist jobs in Springfield, MA, the most frequently searched job titles are:
What job categories do people searching Insurance Verification Specialist jobs in Springfield, MA look for? The top searched job categories for Insurance Verification Specialist jobs in Springfield, MA are:
What cities near Springfield, MA are hiring for Insurance Verification Specialist jobs? Cities near Springfield, MA with the most Insurance Verification Specialist job openings:
Insurance Verification Specialist jobs near you
Infographic showing various Insurance Verification Specialist job openings in Springfield, MA as of July 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 50% In-person, and 50% Remote job distribution, with an average salary of $39,110 per year, or $18.8 per hour.
Pharmacy Benefit Verification Specialist

Pharmacy Benefit Verification Specialist

Onco360

Hartford, CT • Remote

$24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago

Onco360 rating

7.7

Company rating: 7.7 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

20th of 109 rated pharmacies

Job description

Onco360 Pharmacy is looking for Pharmacy Benefit Verification Specialists for our Specialty Oncology Pharmacy.
As our company continues to grow, we strive to hire new team members with a passion for making a difference in our patient's lives.
Full-Time position may work remotely but MUST HAVE ACTIVE CONNECTICUT PHARMACY TECHNICIAN credentials from the State Board of Pharmacy.
Shift times are between 8am and 8pm.
**Starting salary at $24HR and up**
Sign-On Bonus: $5,000 for employees starting before August 31, 2026.
We also offer quarterly incentive bonuses.
We offer a variety of benefits including:
  • Medical, Dental amp; Vision insurance
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Paid Volunteer Day
  • Floating Holiday
  • Referral Incentive
  • Paid Life, and short amp; long-term disability insurance
Pharmacy Benefit Verification Summary
The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.
Pharmacy Benefit Verification Specialist Major Responsibilities:
  • Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.
  • Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.
  • Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.
  • Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.
  • Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.
  • Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.
  • Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws
  • Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.
  • Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
Pharmacy Benefit Verification Specialist Qualifications:
  • Education/Learning Experience
    • Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification
    • Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience
  • Work Experience
    • Required: 1+ years pharmacy or benefit verification experience
    • Desired: 3+ years pharmacy or benefit verification experience
  • Licenses/Certifications
    • Required: Pharmacy Technician License/Registration with Board of Pharmacy, as required by state law
  • Skills/Knowledge:
    • Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.
  • Behavior Competencies
    • Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skill
Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking Pharmacy Benefit Verification Specialists who go above and beyond for our patients, and also passionate about helping others.

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