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Insurance Verification Specialist Jobs in Springfield, MA

Travelers

AVP, Complex Claim Liability Specialist

Hartford, CT

$132K - $219K/yr

  • Medical

  • Life

  • Retirement

  • PTO

... insurers in the industry for over 170 years. Join us to discover a culture that is rooted in ... Verify the nature and extent of injury or property damage by obtaining and reviewing appropriate ...

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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 Aug 18, 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 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 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.

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 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.

Is it hard to learn insurance verification specialist?

Learning to become an insurance verification specialist involves understanding insurance policies, billing procedures, and using verification tools or software. While some prior knowledge of healthcare or insurance is helpful, training is typically provided, and the role emphasizes attention to detail and communication skills rather than complex technical expertise.

What is the role of an insurance verification specialist?

An insurance verification specialist reviews and confirms patients' insurance coverage to ensure services are authorized and billed correctly. They gather insurance information, verify benefits, and communicate with insurance companies to prevent claim denials, often using specialized software and maintaining attention to detail. This role is essential for accurate billing and smooth patient care processes.
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The top searched job categories for Insurance Verification Specialist jobs in Springfield, MA are:

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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 August 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.

Claims Specialist - Professional Liability

Philadelphia Insurance Companies

Glastonbury, CT • On-site, Remote

$95K - $105K/yr

Full-time

Medical, Retirement, PTO

Re-posted 22 days ago

Philadelphia Insurance Companies rating

8.9

Company rating: 8.9 out of 10

Based on 11 frontline employees who took The Breakroom Quiz

47th of 309 rated insurance

Job description

Marketing Statement:

Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best.

We are looking for a Claims Specialist - Professional Liability to join our team!

JOB SUMMARY

  • Investigate, evaluate and settle more complex first and third-party commercial insurance property claims.

JOB RESPONSIBILITIES

  • Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner.
  • Communicates with all relevant parties and documents communication as well as results of investigation.
  • Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts.
  • Travel is required to attend customer service calls, mediations, and other legal proceedings.

JOB REQUIREMENTS

  • High School Diploma; Bachelor's degree from a four-year college or university preferred.
  • 10 plus years related experience and/or training; or equivalent combination of education and experience.

National Range: $95,000.00 - $105,000.00

Ultimate salary offered will be based on factors such as applicant experience and geographic location.

We offer a hybrid work model that provides flexibility to work remotely while maintaining meaningful in-office collaboration with your team.

Remote consideration will be given to qualified candidates located outside of the primary geographic region.

EEO Statement:

Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc.and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.

Benefits:

We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online.
Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at https://www.phly.com/Careers/default.aspx

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