Hybrid/Remote Insurance Verification and Billing Specialist

• We are open to considering a fully remote position
• M-F, 40 hours The Insurance Verification & Billing Specialist is responsible for all aspects of insurance verification, billing, and collections to ensure accurate and timely reimbursement for services rendered.

This role requires strong knowledge of insurance requirements, account management, and denial resolution, as well as excellent communication skills to support patients, staff, and payors. The Specialist works closely with the Billing team, serving as backup when needed, and plays a key role in maintaining compliance with all regulatory and organizational policies.

• Verify insurance eligibility, referrals, and authorizations for patients prior to services.
• Verify insurance eligibility, referrals, and authorizations for patients prior to services. Responsible to ensure all required insurance verifications (IVs) and authorizations are completed, including intake forms and referrals.
• Document insurance and authorization verification accurately in the CT system.
• Maintain current knowledge of insurance requirements and updates.
• Oversee processing of insurance claims and patient payments.
• Generate, submit, and follow up on insurance claims to ensure timely reimbursement.
• Maintain and monitor accounts receivable (A/R) aging reports weekly, actively managing client payments and insurance A/R.
• Ensure collections and denials are followed up on promptly and effectively.
• Review denied or rejected claims, prepare and submit appeals as needed.
• Resolve insurance denials, rejections, and discrepancies.
• Prepare financial reports and assist with process improvements to optimize revenue cycle management.
• Make weekly collection calls and communicate with patients regarding financial policies, balances, and payment options.
• Resolve billing questions from parents, clients, and SPED administrators.
• Handle telephone and email inquiries from clients, patients, and third parties.
• Contact parents when being discharged to settle any balances.

Qualifications:

High School graduate or equivalent. Associate's or more advanced degree preferred 5 years' experience in a medical office, hospital, outpatient clinic, or other health care settings. Knowledge of medical terminology Minimum of two-year insurance verification experience with knowledge of billing coding Computer literacy Excellent phone skills with an emphasis on customer service Organizational skills Must have experience working with insurance companies, have extensive knowledge of different types of coverage and policies Ability to multi-task, detail oriented, organized ability to maintain accurate records, work quickly to process items in a timely manner, work well with others

Job Types:

Part-time, Full-time Pay:

$22.00 - $26.00 per hour

Experience:

Medical billing: 5 years (Required) Insurance verification: 5 years (Required)

Work Location:

Hybrid remote in Wakefield, MA 01880