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Remote Insurance Verification Jobs in Austin, TX

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Remote Insurance Verification information

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$12

$18

$26

How much do remote insurance verification jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for remote insurance verification in Austin, TX is $18.70, according to ZipRecruiter salary data. Most workers in this role earn between $16.20 and $20.00 per hour, depending on experience, location, and employer.

What is a remote insurance verification specialist?

A Remote Insurance Verification Specialist is a professional who works from a remote location to confirm patients' insurance coverage and benefits. They communicate with insurance companies, healthcare providers, and patients to ensure that medical procedures or services are covered by the patient's insurance plan. These specialists play a crucial role in preventing billing issues and ensuring that claims are processed accurately and efficiently. Their work helps healthcare organizations minimize denials and delays in reimbursement. The position typically requires strong communication skills, attention to detail, and familiarity with insurance policies and medical terminology.

What are some common challenges faced in a remote insurance verification role, and how can I overcome them?

In a remote insurance verification role, one common challenge is navigating varying insurance policies and provider requirements, which can lead to delays or errors if not carefully reviewed. Communication can also be more complex when collaborating virtually with healthcare providers, patients, or insurance companies. To overcome these challenges, staying organized with detailed documentation, utilizing reliable communication tools, and proactively clarifying any uncertainties with team members or clients can help maintain efficiency and accuracy. Regular training and staying updated on industry changes also contribute to success in this role.

What are the key skills and qualifications needed to thrive as a remote insurance verification specialist, and why are they important?

To thrive as a Remote Insurance Verification Specialist, you need a solid understanding of health insurance policies, medical terminology, and experience with insurance verification processes, often supported by a high school diploma or relevant certification. Proficiency in insurance portals, electronic health record (EHR) systems, and spreadsheet software is typically required. Strong attention to detail, organizational skills, and effective communication are essential soft skills for handling sensitive patient data and coordinating with providers. These abilities are vital to ensure accurate insurance verification, prevent claim denials, and support smooth healthcare operations.

What is the difference between Remote Insurance Verification vs Remote Claims Processing Specialist?

AspectRemote Insurance VerificationRemote Claims Processing Specialist
Primary RoleVerify insurance coverage and eligibilityReview and process insurance claims for reimbursement
Required SkillsKnowledge of insurance policies, data entry, attention to detailClaims review, documentation, problem-solving
Work EnvironmentRemote, healthcare or insurance companiesRemote, healthcare or insurance companies
CertificationsInsurance verification or billing certifications often preferredClaims processing certifications may be beneficial

Remote Insurance Verification and Remote Claims Processing Specialist roles both operate in the insurance and healthcare industries, often remotely. While verification focuses on confirming coverage details, claims processing involves reviewing and managing claims for reimbursement. Both roles require attention to detail and familiarity with insurance policies, but they differ in their specific responsibilities and certifications.

How to become a remote insurance verification specialist?

To become a remote insurance verification specialist, candidates typically need a high school diploma or equivalent, strong attention to detail, and familiarity with insurance policies and billing procedures. Relevant skills include data entry, communication, and proficiency with electronic health record (EHR) systems or insurance verification software. Some employers may prefer candidates with healthcare or insurance industry experience and may require certification in medical billing or coding.
More about Remote Insurance Verification jobs

What are the most commonly searched types of Insurance Verification jobs in Austin, TX?

The most popular types of Insurance Verification jobs in Austin, TX are:

What are popular job titles related to Remote Insurance Verification jobs in Austin, TX?

For Remote Insurance Verification jobs in Austin, TX, the most frequently searched job titles are:

What job categories do people searching Remote Insurance Verification jobs in Austin, TX look for?

The top searched job categories for Remote Insurance Verification jobs in Austin, TX are:

What cities near Austin, TX are hiring for Remote Insurance Verification jobs?

Cities near Austin, TX with the most Remote Insurance Verification job openings:

Remote Insurance Verification jobs near you
Infographic showing various Remote Insurance Verification job openings in Austin, TX as of September 2026, with employment types broken down into 73% Full Time, 23% Part Time, and 4% Contract. Highlights an 100% Remote job distribution, with an average salary of $38,902 per year, or $18.7 per hour.

Member and Provider Services Specialist

Austin, TX • On-site, Remote

Harbor Health
See more jobs at Harbor Healthexternal

$17 - $21/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

This job post has expired 2 days ago. Applications are no longer accepted.

Key responsibilities

  • Support members and providers by addressing inquiries related to benefits, coverage, claims, billing, referrals, and prior authorizations.

  • Verify member eligibility and benefits, and assist with enrollment, portal registration, and digital self-service tools.

  • Research and resolve claims and billing issues, and document all interactions while maintaining compliance and confidentiality.

Job description

Description
Harbor Health
Remote - Texas Based
POSITION OVERVIEW
Harbor Health is seeking a compassionate, highly skilled, and solution-oriented Member & Provider Services Specialist to join our innovative, integrated healthcare organization. As a key ambassador of the Harbor Health experience, you will serve as a trusted resource for members, providers, and business partners by delivering exceptional service across both our health plan and medical group. You will support a broad spectrum of member and provider inquiries throughout the healthcare journey - including educating members on benefits and coverage, resolving claims and billing questions, supporting enrollment and eligibility, assisting with referrals and prior authorizations, and managing complaints, grievances, and appeals in accordance with regulatory requirements. This role is central to delivering Harbor Health's commitment to a unified, frictionless, member-centered experience that aligns with our mission of transforming healthcare through our payvider model.
POSITION DUTIES & RESPONSIBILITIES
Member Services
  • Serve as the primary point of contact for members through phone, email, chat, and other communication channels
  • Educate members regarding health plan benefits, eligibility, covered services, exclusions, deductibles, copays, coinsurance, and out-of-pocket responsibilities
  • Assist members with provider selection, appointment scheduling, referrals, and navigation throughout the healthcare system
  • Guide members through enrollment, eligibility updates, PCP changes, and Marketplace or Large Group insurance questions
  • Assist members with portal registration and digital self-service tools
  • Promote first-call resolution while delivering a personalized, empathetic member experience

Provider Services
  • Serve as a primary resource for participating and non-participating providers
  • Support provider inquiries regarding member eligibility, benefits, claim status, payment, referrals, prior authorizations, and network participation
  • Educate providers on Provider Relations and Network Management processes to resolve provider concerns efficiently

Eligibility & Benefits
  • Verify member eligibility and benefits using Athena, payer portals, and internal systems
  • Confirm benefit coverage, network participation, plan limitations (HMO, PPO, POS, Marketplace, etc.), and applicable member financial responsibility
  • Educate members regarding referral requirements and available in-network resources to improve access and reduce out-of-pocket costs
  • Resolve eligibility discrepancies by working directly with health plans or guiding members through corrective actions

Claims & Billing Support
  • Research and resolve claims inquiries for members and providers
  • Explain claim adjudication, payment determinations, denials, coordination of benefits, and reimbursement processes
  • Assist with billing questions, patient balances, payment options, and payment plan information
  • Escalate complex financial or reimbursement issues to Claims or Billing teams while maintaining ownership of the member experience

Prior Authorization & Referrals
  • Educate members and providers regarding prior authorization requirements, referral processes, and documentation needs
  • Explain authorization status, next steps, and expected turnaround times
  • Coordinate with Utilization Management and Clinical Operations to facilitate timely resolution

Appeals, Grievances & Complaints
  • Intake and document member and provider complaints, grievances, and appeals accurately and completely
  • Ensure all required documentation is collected to support investigations and regulatory review
  • Maintain compliance with CMS, TDI, NCQA, HIPAA, and Harbor Health policies
  • Escalate potential compliance, quality of care, patient safety, or regulatory issues appropriately

Network Access & Care Navigation
  • Identify access-to-care concerns and potential network adequacy issues
  • Assist members in locating participating providers and obtaining timely appointments
  • Escalate network access barriers in accordance with regulatory access standards
  • Support members through complex care coordination and navigation needs

Documentation & Communication
  • Manage high-volume inbound and outbound phone calls, emails, and written correspondence
  • Accurately document all member and provider interactions in applicable systems
  • Maintain detailed case notes while ensuring confidentiality of Protected Health Information (PHI)
  • Follow approved communication standards while personalizing interactions to meet individual member needs

Operational Excellence
  • Meet established quality, productivity, attendance, and service level expectations
  • Demonstrate flexibility in a rapidly evolving healthcare environment
  • Participate in ongoing training, coaching, and professional development
  • Support continuous improvement initiatives designed to enhance the member and provider experience

DESIRED PROFESSIONAL SKILLS & EXPERIENCE
  • High School Diploma or equivalent; Associate's or Bachelor's degree preferred
  • 2+ years of experience in a healthcare contact center, member services, or provider services role
  • Working knowledge of health insurance operations including eligibility, benefits, claims, prior authorizations, referrals, and appeals/grievances processes
  • Familiarity with CMS, TDI, NCQA, and HIPAA compliance requirements as they relate to member and provider services
  • Proficiency with EMR and payer portal systems; experience with Athena a plus
  • Exceptional customer service, communication, and active listening skills
  • Strong analytical and problem-solving skills with the ability to navigate multiple systems simultaneously
  • Ability to manage high call and case volume while maintaining accuracy and compassion
  • Demonstrated ability to work collaboratively across cross-functional teams
  • Strong attention to detail and documentation discipline
  • Preferred: Experience in a payvider, integrated delivery system, or health plan environment
  • Preferred: Familiarity with Medicare Advantage, Medicaid, ACA Marketplace, or employer group insurance products
  • Preferred: Experience handling appeals, grievances, or regulatory complaint processes
  • Preferred: Knowledge of medical terminology, CPT/ICD-10 coding, or claims adjudication
  • Preferred: Bilingual in English/Spanish

WHAT WE OFFER
  • Competitive salary and incentives
  • Generous PTO
  • 10 paid holidays
  • Medical, Dental, and Vision Insurance
  • 401(k) Investment Plan
  • Company Equity
  • Professional development and growth opportunities

COMPANY OVERVIEW
At Harbor Health, we're transforming healthcare in Texas through collaboration and innovation. We're seeking passionate individuals to help us create a member-centered experience that connects comprehensive care with a modern payment model. If you're ready to make a meaningful impact in a dynamic environment where your contributions are valued, please bring your talents to our team!
EQUAL EMPLOYMENT OPPORTUNITY STATEMENT
Harbor Health is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other status protected by applicable federal, state, or local law. All employment decisions are based on qualifications, merit, and business need.

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