Insurance Verification Specialist (DAC)

Insurance Verification Specialist (DAC) Boca Raton, FL Job Details Full-time 1 day ago Qualifications Collaborate with healthcare professionals Insurance prior authorization Medicare Achieving HIPAA compliance Maintaining patient confidentiality HIPAA Mid-level

ICD-10 EMR/EHR CPT

coding Organizational skills Patient interaction Care coordination Escalation handling Communication skills

Full Job Description Job Title:

Insurance Benefits Coordinator Location:

Rendon Center Dermatology Employment Type:

Full-Time Position Overview The Insurance Benefits Coordinator is responsible for verifying patient insurance coverage and accurately determining financial responsibility prior to services rendered. This role is essential to ensuring a seamless patient experience, minimizing claim denials, and supporting the financial health of the practice. The ideal candidate is highly detail-oriented, proactive, and experienced in navigating insurance plans, benefits, and authorization requirements in a fast-paced clinical environment. Key Responsibilities Insurance Verification Verify patient insurance eligibility and benefits for scheduled services and procedures Confirm coverage details including deductibles, co-pays, co-insurance, and out-of-pocket maximums Identify plan limitations, exclusions, and referral requirements Patient Financial Responsibility Accurately calculate and communicate patient financial responsibility prior to appointments Provide clear explanations of benefits and expected costs to patients Document all benefit details and patient estimates in the EMR Pre-Authorizations & Referrals Determine if prior authorizations or referrals are required for procedures Initiate and track authorization requests to ensure timely approvals Follow up on pending authorizations to avoid delays in patient care Coordination with Clinical & Front Desk Teams Communicate insurance findings and patient responsibility to providers and front desk staff Ensure schedules are aligned with authorization status and coverage requirements Collaborate with clinical staff to confirm procedure codes and medical necessity Claims Support & Denial Prevention Review benefits prior to service to reduce claim denials and rework Identify potential coverage issues and escalate as needed Assist billing team with insurance-related inquiries when necessary Documentation & Compliance Maintain accurate and thorough documentation of all insurance verifications Ensure compliance with payer guidelines and office policies Adhere to HIPAA and patient confidentiality standards Qualifications Previous experience in medical insurance verification required (dermatology preferred) Strong knowledge of insurance plans, including commercial, Medicare, and Medicaid Familiarity with

CPT/ICD-10

codes and prior authorization processes Experience with EMR systems (ModMed preferred) Excellent communication and organizational skills Ability to manage high-volume workload with accuracy and efficiency Key Competencies Attention to

Detail:

Ensures accuracy in benefit verification and cost estimates

Accountability:

Takes ownership of patient financial clearance before visits

Communication:

Clearly explains insurance coverage and costs to patients and staff

Problem-Solving:

Identifies and resolves coverage issues proactively

Efficiency:

Works quickly while maintaining high accuracy