VA Health Insurance Verification Specialist

A Benefits Verification Specialist verifies patient insurance coverage, benefits, and financial responsibility before services are provided. The work prevents the worst kind of billing surprise - services delivered without coverage, leaving the patient with full financial responsibility and the practice with collection challenges. Strong benefits verification protects patients and practices both. The Specialist is the role that ensures everyone knows what's covered before care begins.

Key Responsibilities

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Verify Coverage:

Check patient insurance eligibility, active policy dates, and benefits before scheduled procedures.

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Manage Authorizations:

Secure pre-certifications and referrals for inpatient or outpatient care.

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Handle Billing Data:

Update electronic health records and billing systems with correct payer and policy details.

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Resolve Issues:

Communicate with insurance companies and patients to fix coverage discrepancies or answer cost inquiries.

Requirements and Qualifications

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Education:

High school diploma or GED certificate; an associate degree is often preferred.

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Experience:

Minimum 1 to 2 years of experience in medical billing, insurance verification, or healthcare revenue cycles.

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Skills:

Knowledge of medical terminology and CPT codes.

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Technology:

Familiarity with VA electronic health record systems and insurance verification portals. (VistA, CPRS, Integrated Billing, etc.)

HealthCare Resolution Services

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